Long tours put new vets at greater risk

The incidence of posttraumatic stress disorder is likely to be significantly higher in the current population of veterans because of long and repeated tours of duty, said Dr. John A. Renner Jr., associate chief of psychiatry at the VA Boston Healthcare System.

Clinicians and scientists have known since the 1960s that 1 year is about the ideal time frame for exposure to combat in order to limit the incidence of PTSD, but today a large cohort of troops has had repeated exposures of more than 1 year, said Dr. Renner, also a faculty member at Boston University.

"I think statistically we can just predict that that's going to have a major impact," Dr. Renner said during a panel discussion on substance abuse and mental health among veterans and active duty military sponsored by the National Center on Addiction and Substance Abuse (CASA) at Columbia University.

Other experts at the meeting agreed that veterans of the Iraq and Afghanistan conflicts were facing unprecedented circumstances and levels of stress.

These soldiers are 22- and 23-year-olds who have been deployed two, three, or four times in many cases, said Dr. Loree K. Sutton, a brigadier general who serves as director of the Defense Centers of Excellence for Psychological Health and Traumatic Brain Injury in Arlington, Va., part of the Department of Defense Military Health System.

Adding to that stress is the potential for exposure to improvised explosive devices. Even soldiers who are within a mile of the epicenter of the explosion are subject to fragment injuries, she said.