Risk of depressive disorder following disasters and military deployment: systematic review with meta-analysis

TY - JOUR

T1 - Risk of depressive disorder following disasters and military deployment

T2 - systematic review with meta-analysis

AU - Bonde, J. P.

AU - Utzon-Frank, Nicolai

AU - Bertelsen, M.

AU - Borritz, M.

AU - Eller, N. H.

AU - Nordentoft, M.

AU - Olesen, K.

AU - Rod, N. H.

AU - Rugulies, R.

N1 - © The Royal College of Psychiatrists 2016.

PY - 2016/4

Y1 - 2016/4

N2 - BACKGROUND: Numerous studies describe the occurrence of post-traumatic stress disorder following disasters, but less is known about the risk of major depression.AIMS: To review the risk of depressive disorder in people surviving disasters and in soldiers returning from military deployment.METHOD: A systematic literature search combined with reference screening identified 23 controlled epidemiological studies. We used random effects models to compute pooled odds ratios (ORs).RESULTS: The average OR was significantly elevated following all types of exposures: natural disaster OR = 2.28 (95% CI 1.30-3.98), technological disaster OR = 1.44 (95% CI 1.21-1.70), terrorist acts OR = 1.80 (95% CI 1.38-2.34) and military combat OR = 1.60 (95% CI 1.09-2.35). In a subset of ten high-quality studies OR was 1.41 (95% CI 1.06-1.87).CONCLUSIONS: Disasters and combat experience substantially increase the risk of depression. Whether psychological trauma per se or bereavement is on the causal path is unresolved.

AB - BACKGROUND: Numerous studies describe the occurrence of post-traumatic stress disorder following disasters, but less is known about the risk of major depression.AIMS: To review the risk of depressive disorder in people surviving disasters and in soldiers returning from military deployment.METHOD: A systematic literature search combined with reference screening identified 23 controlled epidemiological studies. We used random effects models to compute pooled odds ratios (ORs).RESULTS: The average OR was significantly elevated following all types of exposures: natural disaster OR = 2.28 (95% CI 1.30-3.98), technological disaster OR = 1.44 (95% CI 1.21-1.70), terrorist acts OR = 1.80 (95% CI 1.38-2.34) and military combat OR = 1.60 (95% CI 1.09-2.35). In a subset of ten high-quality studies OR was 1.41 (95% CI 1.06-1.87).CONCLUSIONS: Disasters and combat experience substantially increase the risk of depression. Whether psychological trauma per se or bereavement is on the causal path is unresolved.

KW - Journal Article

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

KW - Review

U2 - 10.1192/bjp.bp.114.157859

DO - 10.1192/bjp.bp.114.157859

M3 - Review

C2 - 26892850

SN - 0960-5371

VL - 208

SP - 330

EP - 336

JO - The Journal of mental science

JF - The Journal of mental science

IS - 4

ER -