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Deployment, combat, and risk of multiple physical symptoms in the US military: A prospective cohort study.

Publication Status: Published

Sponsoring Organization: Defense Health Agency (formerly TRICARE Management Activity)

Sponsoring Office: Defense Centers of Excellence for Psychological Health and Traumatic Brain Injury

Congressionally Mandated: No

Funding Source: Undetermined

Release Date/Publication: December 01, 2015

Principle Investigator Status: Government

Primary DoD Data Source: Millenium Cohort Study

Secondary DoD Data Source:


Multiple physical symptoms (MPS) have historically been observed after deployment to a combat zone and are often disabling in nature. This study examined longitudinal trends in MPS status and its relationship to deployment in U.S. military service members.

Using longitudinal data from panel 1 participants in the Millennium Cohort Study (n = 76,924), MPS status was assessed at three time points (2001-2008) using the 15-item Patient Health Questionnaire. Probability of reporting MPS was analyzed using mixed-effects multinomial logit regression, with time and deployment experience as main explanatory variables.

After adjustment for demographic, military, and health characteristics, service members who deployed with combat were significantly more likely to report MPS at each time point compared with those not deployed (odds ratio [OR] and 95% confidence interval [CI] for wave 1 = 1.49 [1.47-1.52], wave 2 = 1.73 [1.69-1.78], wave 3 = 2.08 [2.03-2.12]), and those who deployed without combat (OR and CI for wave 1 = 2.66 [2.59-2.74], wave 2 = 1.81 [1.75-1.87]; wave 3 = 1.68 [1.63-1.74]).

Longitudinal trends indicate that the probability of reporting MPS has increased consistently over time only for those deployed, regardless of combat experience.


McCutchan PK, Liu X, LeardMann CA, Smith TC, Boyko EJ, Gore KL, Freed MC, Engel CC. Deployment, combat, and risk of multiple physical symptoms in the US military: A prospective cohort study. Ann Epidemiol. 2015 Dec 11.

Last Updated: February 21, 2019
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