Anxiety disorders rose steadily among active US service members

In the past 13 years, 217,409 incidents of anxiety disorders were diagnosed among the active component of the US Armed Forces, according to data from the Armed Forces Health Surveillance Center's Medical Surveillance Monthly Report.

"In the US Armed Forces, mental disorders ... are a leading cause of morbidity, disability, health care service utilization, lost duty time and attrition from military service," Army Col. William Corr, deputy director of the division of epidemiology and analysis at the Armed Forces Health Surveillance Center, said in a press release. "Incidence rates of mental disorders diagnoses overall and anxiety disorders in particular have increased sharply among US military members during the past 10 years."

From 2000 to 2012, the unadjusted incidence rate of anxiety disorder diagnosis among active members of the US Army, Navy, Air Force, Marine Corps and Coast Guard was 117.2 per 10,000 person-years.

"Non-specific anxiety disorder" was the first anxiety disorder-related diagnosis among 205,717 incident cases. According to the report, more specific anxiety-related disorders were diagnosed among many of these active members, including generalized anxiety (14.3%), panic disorder without agoraphobia (8.2%), specified phobic disorders (4.5%) and obsessive-compulsive disorder (1.6%).

However, researchers said a more specific diagnosis was not made among 76.6% of those whose incident diagnoses were one of the non-specific anxiety disorders.

"The finding suggests that most anxiety disorders among service members lack the clinical hallmarks of more specific anxiety disorders, are eventually attributed to other, commonly co-occurring conditions such as depressive disorders, or are self-limited responses to stresses associated with life events," researchers wrote.

"Anxiety states" comprised the most cases of anxiety disorder; members of the Army, recruits, enlisted members and those in health care occupations had significantly higher rates of anxiety state diagnoses compared with their counterparts, according to the press release.

Additionally, within 1 year before or after their case-defining anxiety disorder encounter, about one-third of service members diagnosed with an anxiety disorder also were diagnosed with an adjustment (34.3%) or a depressive (33.5%) disorder.

Phobic disorders accounted for 21,675 cases and obsessive-compulsive disorders accounted for 8,370 cases.

In terms of health care burdens during the 13-year period, anxiety disorders were responsible for 93,992 hospital bed days; researchers noted a 316% increase in anxiety disorder-related hospital bed days from the first to the last year of the study period.

"[T]his report documents that, in addition to increasing rates of diagnoses of anxiety disorders, the overall health care burden (eg, medical encounters, hospital bed days, individuals affected) associated with anxiety disorder evaluation and treatment has also increased dramatically over the past 13 years," researchers wrote. "Significant increases in resources to identify and treat mental disorders among service members and successes in reducing stigmatization for seeking care for anxiety symptoms likely contribute to such increases."

In the past 13 years, 217,409 incidents of anxiety disorders were diagnosed among the active component of the US Armed Forces, according to data from the Armed Forces Health Surveillance Center's Medical Surveillance Monthly Report.

"In the US Armed Forces, mental disorders ... are a leading cause of morbidity, disability, health care service utilization, lost duty time and attrition from military service," Army Col. William Corr, deputy director of the division of epidemiology and analysis at the Armed Forces Health Surveillance Center, said in a press release. "Incidence rates of mental disorders diagnoses overall and anxiety disorders in particular have increased sharply among US military members during the past 10 years."

From 2000 to 2012, the unadjusted incidence rate of anxiety disorder diagnosis among active members of the US Army, Navy, Air Force, Marine Corps and Coast Guard was 117.2 per 10,000 person-years.

"Non-specific anxiety disorder" was the first anxiety disorder-related diagnosis among 205,717 incident cases. According to the report, more specific anxiety-related disorders were diagnosed among many of these active members, including generalized anxiety (14.3%), panic disorder without agoraphobia (8.2%), specified phobic disorders (4.5%) and obsessive-compulsive disorder (1.6%).

However, researchers said a more specific diagnosis was not made among 76.6% of those whose incident diagnoses were one of the non-specific anxiety disorders.

"The finding suggests that most anxiety disorders among service members lack the clinical hallmarks of more specific anxiety disorders, are eventually attributed to other, commonly co-occurring conditions such as depressive disorders, or are self-limited responses to stresses associated with life events," researchers wrote.

"Anxiety states" comprised the most cases of anxiety disorder; members of the Army, recruits, enlisted members and those in health care occupations had significantly higher rates of anxiety state diagnoses compared with their counterparts, according to the press release.

Additionally, within 1 year before or after their case-defining anxiety disorder encounter, about one-third of service members diagnosed with an anxiety disorder also were diagnosed with an adjustment (34.3%) or a depressive (33.5%) disorder.

Phobic disorders accounted for 21,675 cases and obsessive-compulsive disorders accounted for 8,370 cases.

In terms of health care burdens during the 13-year period, anxiety disorders were responsible for 93,992 hospital bed days; researchers noted a 316% increase in anxiety disorder-related hospital bed days from the first to the last year of the study period.

"[T]his report documents that, in addition to increasing rates of diagnoses of anxiety disorders, the overall health care burden (eg, medical encounters, hospital bed days, individuals affected) associated with anxiety disorder evaluation and treatment has also increased dramatically over the past 13 years," researchers wrote. "Significant increases in resources to identify and treat mental disorders among service members and successes in reducing stigmatization for seeking care for anxiety symptoms likely contribute to such increases."