Deployment and Mental Health Diagnoses Among Children of US Army Personnel

Objective: To characterize the risk of mental health diagnoses among children of US military personnel associated with parental deployment in support of Operation Iraqi Freedom (OIF) and Operation Enduring Freedom (OEF). Design: Nonrandomized, retrospective cohort study (2003-2006). Setting: Electronic medical record data for outpatient care. Participants: Children (N = 307 520) aged 5 to 17 years with at least 1 active-duty US Army parent. Main Exposure: Number of months of parental deployment for OIF and OEF. Main Outcome Measures: A mental health diagnosis was defined as having at least 1 mental health-related International Classification of Diseases, Ninth Revision, code out of 4 possible codes for a given outpatient medical visit. Diagnoses were further classified into 1 of 17 disorder categories. Results: Overall, children with parental deployment represented an excess of 6579 mental health diagnoses during the 4-year period compared with children whose parents did not deploy. After the children's age, sex, and mental health history were adjusted for, excess mental health diagnoses associated with parental deployment were greatest for acute stress reaction/adjustment, depressive, and pediatric behavioral disorders and increased with total months of parental deployment. Boys and girls showed similar patterns within these same categories, with more diagnoses observed in older children within sex groups and in boys relative to girls within age groups. Conclusions: A dose-response pattern between deployment of a parent for OIF and OEF and increased mental health diagnoses was observed in military children of all ages. Findings may be used to inform policy, prevention, and treatment efforts for military families facing substantial troop deployments.