Mental Health
Cognitive complaints predict persistent probable depression in U.S. military personnel James K. Romine* Andrew MacGregor Amber Dougherty Diane Williams
Introduction: Depression is a significant health burden on the U.S. military and can lead to long-term quality of life issues and suicidal thoughts and behavior. While the military incorporates screening tools to identify depression, guidance on patient referral is lacking. As such, investigating additional criteria that could identify higher-risk individuals may help guide referral efforts.
Methods: 1,434 U.S. service members who responded to an initial health assessment upon return from deployment and screened positive for probable depression using the 2-item Patient Health Questionnaire (PHQ-2) were included. A subsequent health assessment was conducted 3-18 months later that also used the PHQ-2 and identified those with persistent probable depression. Fourteen health complaints were assessed in the initial assessment. A multivariable logistic regression model examined the predictive effect of these health complaints on persistent probable depression, after adjusting for demographic factors and time between assessments. ORs and 95% CIs were calculated.
Results: Overall, 26.9% of service members screened positive for persistent probable depression. In the multivariable regression, only two health complaints were statistically significant. Cognitive complaints, specifically “trouble concentrating on things” (OR 1.49, 95% CI 1.05-2.12) and “hard to make up your mind or make decisions” (OR 1.55, 95% CI 1.15-2.09), were associated with greater risk of persistent probable depression.
Conclusion: This study identified two cognitive complaints associated with persistent probable depression. These results may enhance military screening efforts. Service members who screen positive for probable depression with cognitive complaints may need referral for further care, a process that could be automated. Automated screening and referral efforts would allow more efficient provision of targeted medical care, which may help minimize the mental health burden in the U.S. military.