Illness-induced post-traumatic stress disorder among Canadian Armed Forces Members and Veterans

Gagan K Gill; Jordana L Sommer; Natalie Mota; Jitender Sareen; Renée El-Gabalawy

doi:10.1016/j.janxdis.2021.102472

Illness-induced post-traumatic stress disorder among Canadian Armed Forces Members and Veterans

J Anxiety Disord. 2022 Mar:86:102472. doi: 10.1016/j.janxdis.2021.102472. Epub 2021 Sep 1.

Authors

Gagan K Gill¹, Jordana L Sommer², Natalie Mota³, Jitender Sareen⁴, Renée El-Gabalawy⁵

Affiliations

¹ Department of Psychology, University of Manitoba, Winnipeg, MB R3T 2N2, Canada.
² Department of Psychology, University of Manitoba, Winnipeg, MB R3T 2N2, Canada; Department of Anesthesiology, Perioperative and Pain Medicine, Max Rady College of Medicine, University of Manitoba, 2nd Floor Harry Medovy House, 671 William Avenue, Winnipeg, MB R3E 0Z2, Canada.
³ Department of Psychology, University of Manitoba, Winnipeg, MB R3T 2N2, Canada; Department of Psychiatry, Max Rady College of Medicine, University of Manitoba, PZ433-771 Bannatyne Avenue, Winnipeg, MB R3T 2N2, Canada; Department of Clinical Health Psychology, Max Rady College of Medicine, University of Manitoba, PZ350-771 Bannatyne Avenue, Winnipeg, MB R3E 3N4, Canada.
⁴ Department of Psychology, University of Manitoba, Winnipeg, MB R3T 2N2, Canada; Department of Psychiatry, Max Rady College of Medicine, University of Manitoba, PZ433-771 Bannatyne Avenue, Winnipeg, MB R3T 2N2, Canada.
⁵ Department of Psychology, University of Manitoba, Winnipeg, MB R3T 2N2, Canada; Department of Anesthesiology, Perioperative and Pain Medicine, Max Rady College of Medicine, University of Manitoba, 2nd Floor Harry Medovy House, 671 William Avenue, Winnipeg, MB R3E 0Z2, Canada; Department of Psychiatry, Max Rady College of Medicine, University of Manitoba, PZ433-771 Bannatyne Avenue, Winnipeg, MB R3T 2N2, Canada; Department of Clinical Health Psychology, Max Rady College of Medicine, University of Manitoba, PZ350-771 Bannatyne Avenue, Winnipeg, MB R3E 3N4, Canada; CancerCare Manitoba, 675 McDermot Avenue, Winnipeg, MB R3E 0V9, Canada. Electronic address: renee.el-gabalawy@umanitoba.ca.

PMID: 34531106
DOI: 10.1016/j.janxdis.2021.102472

Abstract

Objectives: There is growing recognition of illness-induced post-traumatic stress disorder (PTSD), defined by illness being the index trauma that induces PTSD symptoms. This is the first study to examine 1) the lifetime prevalence of illness-induced PTSD among military personnel and veterans, and its 2) sociodemographic, military, trauma, and physical health condition correlates.

Methods: Participants completed the 2002 Canadian Community Health Survey-Mental Health and Well-being - Canadian Forces (N = 5155) and the 2018 Canadian Armed Forces Members and Veterans Mental Health Survey follow-up (n = 2941). A semi-structured clinical interview assessed PTSD, which we categorized as "illness-induced" or "other trauma-induced" PTSD based on the index trauma in those participating in both timepoints. To ensure representativeness of our study sample, we used baseline weights created by Statistics Canada to report weighted prevalence estimates and inferential statistics.

Results: The estimated lifetime prevalence of PTSD among the full sample was 22% and 1.5% had lifetime illness-induced PTSD. Among those with lifetime PTSD, the proportion of participants with illness-induced PTSD was 8.3% (91.7% met criteria for other trauma-induced PTSD). In an unadjusted model, the prevalence of illness-induced PTSD was greater for females (13.7%) than males (7.2%), and for those who were not deployed in both 2002 (5.7%) and 2018 (7.1%; unadjusted odds ratio (OR) range: 2.05-3.72). In a multinomial model adjusting for sociodemographic and military characteristics, compared to those with other trauma-induced PTSD, those with illness-induced PTSD had elevated rates of PTSD persistence (24.1% vs. 11.9%; RRR = 6.06, 95% CI [1.21-30.25]) and lower rates of remission (7.8% vs. 19.9%).

Conclusion: Results highlight differences between illness-induced PTSD and other trauma-induced PTSD, primarily the potential chronicity of this manifestation. This may have implications for assessment strategies and targeted interventions.

Keywords: Canadian Armed Forces Members and Veterans Mental Health Survey; Canadian Forces; Epidemiology; Illness-induced PTSD; Post-traumatic stress disorder; Trauma.

Publication types

Research Support, Non-U.S. Gov't

MeSH terms

Canada / epidemiology
Female
Humans
Male
Military Personnel*
Prevalence
Stress Disorders, Post-Traumatic* / diagnosis
Stress Disorders, Post-Traumatic* / epidemiology
Veterans*

Grants and funding

333252/CIHR/Canada