Author and yearof publication | Range/mean/modaldeployment lengthmeasured (months) | Population studiedcountry: servicebranches percentage male | Health outcomes and(standardised measuresused) | Brief summary of deploymentlength and ‘mismatch’ relatedfindings |
Rona et al 14 | Range: <5–≥13 months;mode: 5–8 months (cumulative totals over3 years) | UK: All Services 93% Male | Psychiatric health and well-being(GHQ-12), PTSD (PCL-C), alcoholuse (AUDIT), fatigue (ChalderFatigue), physical symptoms(53-item physical symptomscale) | A total of 13 or more months on deployment over the last 3 years compared with less than 13 months on deployment over the last 3 years was related to higher rates of caseness for PTSD (1.58 (1.07 to 2.32), caseness on the GHQ-12 (1.35 (1.10 to 1.63), more multiple physical symptoms (1.49 (1.19 to 1.87); however these associations were non-significant after adjusting for role in theatre, time spent in a forward area, problems at home, and type of deployment. Deployment length was also related to problems at home during (1.22 (1.00 to 1.48) but not after deployment (1.14 (0.93 to 1.40). The prevalence of severe alcohol problems was found to increase with duration of deployment (test for trend p<0.001). Tours lasting longer than expected led to a significantly increased risk of caseness for PTSD (2.38 (1.21 to 4.65) (figures given as ORs (95% CIs), n=5547). |
Mansfieldet al 24 | Split into 0–11 monthsand > 11 months, nomeasures of spread ordescriptive statistics wereavailable regardingdeployment length | US: Army only 100% male | Mental health diagnoses(ICD-9 codes) | Compared with wives of personnel who were not deployed, women whose husbands were deployed for 1 to 11 months received more diagnoses of depressive disorders (27.4 (22.4 to 32.3) excess cases per 1000 women)), sleep disorders (11.6 (8.3 to 14.8) excess cases per 1000)), anxiety (15.7 (11.8 to 19.6) excess cases per 1000)), and acute stress reaction and adjustment disorders (12.0 (8.6 to 15.4) excess cases per 1000)). Deployment for more than 11 months was associated with 39.3 (33.2 to 45.4) excess cases of depressive disorders, 23.5 (19.4 to 27.6) excess cases of sleep disorders, 18.7 (13.9 to 23.5) excess cases of anxiety, and 16.4 (12.2 to 20.6) excess cases of acute stress reaction and adjustment disorders (figures given as rate differences (95% CIs), n=250626). |
McCarrollet al 25 | Range: 0–12 months | US: Army only 95.1% male | Marital conflict (ConflictTactics Scale) spousalaggression | Soldiers deployed for 0–3, 3–6 and 6–12 months reported significantly higher probabilities of severe aggression towards their spouses relative to non-deployed soldiers (ORs (95% CIs): 0–3 months: 1.16 (1.14 to 1.18); 3–6 months: 1.26 (1.24 to 1.29); 6–12 months: 1.35 (1.32 to 1.37) (n=26835). |
Hotopf et al 20 | Range: 0–17.1 months;mode: 3.1–4.7 months | UK: all services 89.4% male | Psychiatric health and well-being(GHQ-12) and post-traumaticstress reaction | Duration of deployment was not related to either stress syndrome (0–60 days: 1.0; 61–92 days: 1.2 (0.6 to 2.6); 93–144 days: 1.2 (0.6 to 2.5); 145–179 days: 1.0 (0.5 to 2.2); 180–521 days: 1.3 (0.6 to 2.7) or caseness on the GHQ-12 (0–60 days: 1.0; 61–92 days: 0.8 (0.6 to 1.2); 93–144 days: 1.1 (0.8 to 1.6); 145–179 days: 1.0 (0.7 to 1.5); 180–521 days: 1.0 (0.7 to 1.5) (all figures given as ORs (95% CIs), n=6699). |
Adler et al 22 | Range: 1–12 months; mean: 6.5 months | US: all services 63.3% male | Depression (SDS-20) and PTSD(Post-traumatic Stress Scale) | Longer deployments were associated with an increase in depression (R2 =0.73, F(7,3250) 36.43, p<0.001) and PTSD (R2=0.042, F(7,3103) 19.25, p<0.001). However, the relationship between deployment length and elevated distress was found only for male soldiers. When gender was added to the regression analysis, it explained an additional 1% of the variance in depression (∆R2=0.01, p<0.01) and less than 1% of the variance in post-traumatic stress (∆R2=0.00, p<0.05) (n=3339). |
Ames et al 23 | Mean: 8.3 months over 3 yearsfor men; 5 months over 3 yearsfor women | US: Navy only 48.6% male | Alcohol use (how often and howmany drinks typicallyconsumed—self-reported ininterview) | Per 3-month increase, deployment length was associated with a significant increase in perceived peer approval for heavy drinking (in men: β =0.117, t: 3.851, p<0.001; in women: β: 0.160, t: 5.529, p<0.001) and perceived number of drinks had by peers (in men: β =0.191, t: 6.458, p<0.001; in womenβ =0.272, t: 9.532, p<0.001) (n=2380) |
Grieger et al 21 | Mean: 5.0 (SD: 3.1) | US: Army only 95.9% male | PTSD (PCL-C), and depression(PHQ-15) | Longer deployments were not associated with more PTSD at 1, 4 & 7 months, or with later onset, nor more severe symptoms at 1 or 7 months (n=613)*. |
Steel-Fisheret al 26 | Range: 6.3–13.6 months(including expected time ondeployment for those deployedat time of data collection) | US: Army only percentage male not stated | Spouse's well-being/mental health (feelings of depression, anxiety and loneliness), social health (effects on employment, ability to do householdand other daily activities),perceptions of physical health | Tours lasting longer than expected resulted in the deployed partners' spouses reporting significantly poorer perceived mental health (feelings of depression (p<0.000), anxiety (p<0.000) and loneliness (p<0.01)), negative impacts on employment (having to stop work or work fewer hours (p<0.01)), problems with the house and car (p<0.01) and problems communicating with their deployed partner (p<0.01). There were no significant differences based on perceptions of physical health (approximately 20% had worse perceived physical health). Those who had their deployments extended were also deployed on average, longer than those who did not have their deployment extended. (n=798) |
Chaudhuryet al 27 | Mean: 19.46 months(LIC areas); 19.88 months(other areas) | Indian: Army only 100% male | Psychiatric health and well-being(GHQ-12, alcohol (MAST),depression (CRSD)* | Soldiers serving less than 1 year in LIC areas reported significantly fewer cases on CRSD (χ2: 22.36, p<0.01) GHQ-12 (χ2: 14.63, p<0.01), MAST (χ2: 22.81, p<0.01) compared with those serving more than 1 year in LIC areas |
↵* The authors were contacted for further data or effect sizes but were not able to supply these.
↵† Other outcomes were measured (stress and depression by PSQ, anxiety by State and Trait Anxiety Scale, fatigue by MFI, satisfaction with life by SWLS and impact of events/distress by IES) but not in relation to deployment length.
AUDIT, Alcohol use identification test; CRSD, Carroll rating scale for depression; GHQ-12, General health questionnaire-12 item version; ICD-9, International Classification of Diseases 9th Revision; IES, Impacts of events scale; LIC, light-intensity combat; MAST, Michigan alcohol screening test; MFI, Multidimensional fatigue inventory; PCL-C, Post-traumatic symptom checklist-civilian version; PHQ-15, Psychological health questionnaire—15 item version; PSQ, Perceived Stress Questionnaire; PTSD, post-traumatic stress disorder; SDS-20, The Zung Self-Rating Depression Scale—20 item version; SWLS, Satisfaction with life scale.