Combat Injury Profiles Associated With Long-Term Mental Health Outcomes in UK Military Personnel

Researchers used the prospective Armed Services Trauma and Rehabilitation Outcome (ADVANCE) cohort to examine long-term psychosocial outcomes after combat injuries sustained in Afghanistan. The analysis included 523 injured and 524 frequency-matched uninjured UK military personnel, all male, with a median age of 37 years. Assessments occurred a median of 11 years after injury. Validated self-report questionnaires measured probable anxiety, depression, posttraumatic stress disorder (PTSD), alcohol misuse, and mental health multimorbidity.

Among injured nonofficers, adjusted risks relative to uninjured participants were elevated for anxiety (risk ratio, 1.92), depression (1.78), PTSD (2.00), and mental health multimorbidity (2.05). Injuries without limb loss were associated with higher risks, including depression (1.95; 95% CI, 1.47–2.67) and multimorbidity (2.32; 95% CI, 1.52–3.60). Differences associated with limb loss were small or inconclusive. Mild traumatic brain injury (TBI) was associated with depression (2.31; 95% CI, 1.63–3.29) and multimorbidity (2.63; 95% CI, 1.62–4.80); estimates for moderate to severe TBI were generally smaller and less precise. Alcohol misuse associations were small or inconclusive across injury types.

These findings suggest injury profiles may help identify personnel at elevated risk of long-term mental health difficulties. However, observational associations do not establish causality, questionnaire results indicate probable rather than clinically confirmed disorders, and the all-male cohort limits generalizability. Full study methods were unavailable for this assessment.