Risk of Mental Health Disorders Following an Initial Diagnosis of Postpartum Depression, Active Component, U.S. Armed Forces, 1998-2010.

Postpartum depression (PPD) is one of the most common psychiatric conditions of the postpartum period. Several studies have found an association between PPD and other mental health disorders. The Defense Medical Surveillance System (DMSS) was used to identify a cohort of primiparous service women with PPD between 1998 and 2010 and match them by month of delivery to a cohort of women without PPD. During the surveillance period, there were 5,203 incident cases of PPD with a crude rate of 44.9 per 1,000 person-years. Individuals in the PPD cohort, when compared to their matched controls, were at higher risk for subsequent depressive disorders (adjusted hazard ratio [HR]: 7.3 [95% CI: 5.2-10.3]), anxiety disorders (adjusted HR: 3.2 [95% CI: 2.5-4.0]), and bipolar disorders (adjusted HR: 4.7 [95% CI: 1.9-11.9]). There were higher rates of these mental health diagnoses among individuals who eventually left service. Early screening, support, and treatment are essential during this vulnerable postpartum time frame to preserve the female fighting force.

Surveillance of cataract in active component service members, U.S. Armed Forces, 2000-2013.

A cataract is an opacity of the lens that is associated with risk factors such as aging, trauma, cigarette smoking, and exposure to excessive ultraviolet rays from sunlight. Cataracts most commonly affect individuals aged 40 years and older; however, military members can have occupational exposures (e.g., eye injury) that may make them susceptible to developing cataracts at an earlier age. During the 14-year surveillance period (2000-2013), there were 22,418 cases of cataract diagnosed in active component service members; the female-to-male rate ratio was 1.2. Older service members and service members in the Army (128.7 per 100,000 person-years [p-yrs]) had the highest incidence rate of cataract from all causes while the Marine Corps (63.1 per 100,000 person-years [p-yrs]) had the lowest incidence rate. Interestingly, the Marine Corps had the highest incidence rate of traumatic cataract compared to the other Services (10.2 per 100,000 p-yrs).

Risk of type II diabetes and hypertension associated with chronic insomnia among active component, U.S. Armed Forces, 1998-2013.

Chronic insomnia is a common clinical complaint and its incidence in both U.S. military and civilian populations has increased. Several studies have evaluated the association between chronic insomnia and the development of other chronic diseases. This study estimates the incidence of chronic insomnia. In addition, this report examines the association between both hypertension and type II diabetes and chronic insomnia in active component military members. The Defense Medical Surveillance System was used to identify a cohort of individuals with chronic insomnia between 1998 and 2013 and to match them by age and gender with a cohort without insomnia. During 1998-2013, there were 205,740 incident cases of chronic insomnia among active component service members with an overall rate of 90.3 per 10,000 person-years. Individuals in the chronic insomnia cohort were at higher risk for type II diabetes (adjusted hazard ratio [HR], 2.17 [95% CI, 1.75-2.69]) and hypertension (adjusted HR, 2.00 [95% CI, 1.85-2.16]). Sleep hygiene education along with evaluation and treatment of persistent symptoms are of public health importance in active duty service members.