Overview of the studies included (alphabetical order)
| Authors, year of publication | Study design | Sample | Health measures | |||||
|---|---|---|---|---|---|---|---|---|
| Overall sample size | Number of respondents* | Response rate | Country | Service status | Deployment | |||
| Abeyasinghe et al, 2012 | Cross-sectional survey | Not reported | 96 | 88.9% | Sri Lanka | Active duty | Sri Lankan Civil War | 1. PTSD screening questionnaire† |
| Abrams et al, 2006 | Cohort | Not reported | Total: 493 123 with hearing impairment 370 controls | Not reported | US | Not reported | Not reported | 1. ICD-9-CM 2. SF (8-item) 3. IADLs |
| Boakye et al, 2013 | Analysis of records | NA | 168 | NA | US | Veterans | Not reported | 1. Self-reported depression, PTSD, substance abuse 2. BDI 3. SF (12 item) |
| Delimar et al, 1998 Sivik et al, 2000 | Case–control | Not reported | Total: 90 (30 disabling injuries; 30 non-disabling injuries; 30 active soldiers) Total: 120 (30 non-disabling injuries; 30 permanent disabling injuries; 30 active soldiers; 30 recruits not exposed to combat) | Not reported | Croatia | Veterans Active duty ≥3 months combat experience‡ | Croat-Bosniak War | 1. CIDI-PTSD interview 2. MMPI (4 subscales) 3. PTSS 4. IES |
| Desmond et al, 2006, Desmond 2007 | Cross-sectional survey | 2500 questionnaires distributed 1222 returned | 582 138§ | 49% | UK | Not reported | Majority World War II | 1. HADS 2. IES 3. CSI 4. TAPES |
| Doukas et al, 2013 | Cross-sectional survey | 868 | 324 | 59.8% | US | Active duty Reservists | Iraq Afghanistan | 1. CESD-R 2. PCL-M |
| Ebrahimzadeh et al, 2009 | Cross-sectional survey | 200 | 31 | Not reported | Iran | Active duty | Iraq–Iran War | 1. self-reported mental health disorders |
| Fagelson et al, 2007 | Analysis of records | NA | 300 | NA | US | Not reported | Not reported | 1. Clinical Diagnosis DSMI-IV 2. M-PTSD 3. THI 4. TSI |
| Gregurek et al, 1996 | Cross-sectional survey | 60 | 53 | Not reported | Croatia | Active duty | Croatian War of Independence | 1. Clinical interview PTSD 2. M-PTSD 3. STAI |
| Gunawardena et al, 2007 | Case–control | Not reported | Total 922: 461 amputee soldiers 461 non-amputee controls | 98.3% amputee soldiers; 97.6% non-amputees controls | Sri Lanka | Active duty | Not reported | 1. GHQ-30 2. BSI 3. CAGE |
| Hume et al, 1994 | Case–control | Not reported | Total 133: 72 war-wounded (ex-)service personnel 10 severely disabled ex-Contra- guerrillas¶ 51 non-war-wounded (ex-)service personnel | Not reported | Nicaragua | Active duty | Contra War Nicaragua | 1. GHQ-28 2. Clinical assessment PTSD |
| Kasturiaratchi et al, 2004 | Cross-sectional survey | 430 | 408 | Not reported | Sri Lanka | Active duty | Not reported | 1. GHQ-30 2. BSI 3. self-reported alcohol consumption |
| Kim et al, 2006 | Case–control | 135 | Total 132: 56 LDH conscripts (of which 49 complete data) 76 healthy conscripts | Not reported | Korea | NA | Not reported | 1. VAS 2. BDI 3. STAI 4. MINI5. 5. mOSW |
| Martz et al, 2001 | Analysis of records/Case–control | NA | 45 320 | NA | US | Veterans | Not reported | 1. PTSD clinical diagnosis 2. ICD-9 Codes |
| Melcer et al, 2010, Melcer et al, 2013 | Analysis of records | NA | 382 656** | NA | US | Active duty | Iraq Afghanistan | 1. ICD-9 Codes |
| Radnitz et al, 1998, Radnitz et al, 1998 | Case–control | 181 | Total: 140 97 veterans with spinal cord injuries (of which 45 paraplegic and 52 quadriplegic) 43 veterans with non-spinal cord injuries | Not reported | US | Veterans | Not reported | 1. CAPS 2. SCID 3. IES 4. MMSE 5. TSRS |
| Reiber et al, 2010, Epstein et al, 2010, Dougherty et al, 2011 Dougherty et al, 2012, Katon et al, 2013 | Cross-sectional survey | 1042 identified 940 contacted | 581 579†† 134 33 283‡‡ | 65.1% Vietnam war veterans; 58.7% OIF/OEF veterans 61.8% overall | US | Active duty Reserves Veterans | Vietnam War Iraq Afghanistan | 1. SF-36 2. QOL 3. self-reported mental health disorders 4. OPUS 5. PEQ |
*For all the studies the overall number of participants has been reported. In a few cases also the number of participants per specific impairment type has been described.
†Based on the Impact of Event Scale and PTSD symptom Scale.
‡Not professional trained soldiers but had joined the war by spontaneously defending their homes.
§Subsample of the Desmond and MacLachlan46 studies. Only selected participants with an upper-limb amputation.
¶Ex-contra guerrillas refer to soldiers who fought against the Nicaraguan government (and their government soldiers).
**Study population from Melcer et al29 combined with a group of soldiers with serious extremity injuries without amputation.
††Reporting on the same study sample or only reporting on a subsample.
‡‡Reporting on the OIF/OEF subsample from Reiber et al.20
BDI, Beck Depression Inventory; BSI, Bradford Somatic Inventory; CAGE, Screening Test for Alcohol Dependence (CAGE); CAPS, Clinician Administered PTSD Scale; CESD-R, Revised Center for Epidemiologic Studies Depression Scale; CIDI-PTSD, Composite International Diagnostic Interview—PTSD; CSI, coping strategy indicator; DSM, Diagnostic and Statistical Manual; GHQ, General Health Questionnaire; IADLs, instrumental activities of daily living; ICD, International Classification of Disease Codes; ICD-9-CM, International Classification of Disease, Ninth Revision, Clinical Modification Codes; IES, Impact of Event Scale; HADS, Hospital Anxiety and Depression Scale; LDH, lumbar disc herniation; MINI, Mini-International Neuropsychiatric Interview; MMPI, Minnesota Multiphasic Personality Inventory (Hypochondriasis, Depression, Hysteria, Alexithymia); mOSW, Modified Oswestry Low Back Pain Disability Questionnaire; MMSE, Mini-Mental State Examination;M-PTSD, Mississippi Scale for Combat-Related PTSD; NA, not applicable; OIF, Operation Iraqi Freedom; OEF, operation enduring freedom; OPUS, Orthotic and Prosthetic User's Survey; PEQ, Prosthetic Evaluation Questionnaire; PTSD, post-traumatic stress disorder; PCL, PTSD Checklist Military version; PTSS, Post-Traumatic Symptom Scale; QOL, single item measure of Quality of Life; SCI, spinal cord injury; SCID, Structured Clinical Interview for DSM-III-R; SF, Short-Form Health Survey; STAI, State-Trait Anxiety Inventory; TAPES, Trinity Amputation and Prosthesis Experience Scales; THI, Tinnitus Handicap Inventory; TSI, Tinnitus Severity Index; TSRS, Trauma Severity Rating Scale; VAS, Visual Analogue Scale (pain).