Background
Methods
Search syntax and search strategy
Eligibility criteria’s
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Cross-sectional studies whose main purpose was to estimate and determine the prevalence (frequency or percentage) of depression and suicide (thoughts or attempts) in the military.
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Cross-sectional studies that measured depression and suicide (suicidal ideation or attempts) in the military using accredited tools.
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Cross-sectional studies in which the study population was military personnel (serving or retired). Individuals who had been employed by the Army, Air Force, and Navy or retired from any of these organizations. In addition, servicemen who had fought in foreign wars (such as the wars in Afghanistan, Syria, Iraq, and Vietnam) would be considered military forces (active or retired) if surveyed in the selected studies (then they were separately analyzed in subgroup analyzes).
Screening and selection of articles
Data extraction
Quality assessment
Statistical methods
Results
Qualitative results
Authors (Years) | Country | Type of Sampling (Type of Study) | Study Population | Depression Assessment Method | Age (Mean) | Sample size | Prevalence of Depression (%) | NOS Score |
---|---|---|---|---|---|---|---|---|
Tredgold, R. F. (1941)(65) | UK | Convenience Sampling (CS) | Army men | Clinical Symptoms (Interviews) | – | 274 | 70 (25.54%) | 6 |
Helzer, J. E. et al. (1976) (66) | USA | Random Sampling (CS) | Army men | Clinical Symptoms (Interviews) | – | 470 | 122 (26%) | 7 |
Levine, M. E. (1982) (67) | USA | Convenience Sampling (CS) | Army men | Beck Depression Inventory (BDI) | 17 | 200 | 36 (18%) | 6 |
Deeken, M. G. et al. (1987) (68) | USA | Convenience Sampling (CS) | Army men | Zung Self-Rating Depression Scale | – | 298 | 47 (15.77%) | 7 |
Ritchie, E. C. et al. (1992) (69) | USA | Random Sampling (CS) | Army men with HIV | Clinical Symptoms (Interviews) DSM-III-R | – | 50 | 21 (42%) | 7 |
Brown, G. R. et al. (1993) (70) | USA | Random Sampling (CS) | Air Forces men with HIV | Structured Interview Guide for the Hamilton Anxiety and Depression Scales (SIGH-AD) | 35 | 442 | 99 (22.4%) | 8 |
McCarroll, J. E. et al. (1993) (71) | USA | Convenience Sampling (CS) | Army men and women | Clinical Symptoms (Interviews) | 25.4 | 1835 | 87 (4.7%) | 8 |
Male(1565) | 59 (3.8%) | |||||||
Female(270) | 52 (19.3%) | |||||||
Perconte, S. T. et al. (1993) (72) | Russia | Convenience Sampling (CS) | Army men and women | Beck Depression Inventory (BDI) | 29.25 | 591 | 146 (24.70%) | 7 |
Serfaty, E. et al. (1995) (73) | Argentina | Random Sampling (CS) | Army men and women | NR | NR | 553 | 25 (4.5%) | 7 |
Lish, J. D. et al. (1996) (74) | USA | Random Sampling (CS) | Army men and women | Brief self-report questionnaire (SCRENNER) | 21.2 | 669 | 38 (5.81%) | 7 |
Long, N. et al. (1996) (75) | New Zealand | Random Sampling (CS) | Army men | Beck Depression Inventory (BDI) | 50 | 751 | 11 (1.46%) | 7 |
Schwartz, D. A. et al. (1997) (76) | USA | Random Sampling (CS) | Non-Persian Gulf War (PGW) military personnel | Self-report | – | 923 | 157 (17%) | 6 |
Schwartz, D. A. et al. (1997) (76) | USA | Random Sampling (CS) | Persian Gulf War (PGW) military personnel | Self-report | – | 923 | 99 (10.9%) | 6 |
David, D. et al. (1999) (77) | Croatia | Convenience Sampling (CS) | Veterans after participation in Homeland War in Croatia | The Structured Clinical Interview Diagnostic and Statistical Manual (SCID) | 36.2 | 91 | 35 (38.5%) | 7 |
Hankin, C. S. et al. (1999) (78) | USA | Random Sampling (CS) | Men Veterans | Center for Epidemiologic Studies Depression Scale (CES-D Scale) | 62 | 2160 | 676 (31.3%) | 7 |
Hourani, L. L. et al. (1999) (79) | USA | Random Sampling (CS) | Men and Women in the Navy and Marine Corps | Center for Epidemiologic Studies Depression Scale (CES-D Scale) | 20–64 | 782 | 125 (16.08%) | 7 |
Male (321) | 29 (9%) | |||||||
Female (452) | 99 (22%) | |||||||
Curran, G. M. et al. (2000) (80) | USA | Random Sampling (CS) | Men Veterans | (Beck Depression Inventory)BDI( | 43 | 298 | 116 (39%) | 7 |
Menon, A. S. et al. (2000) (81) | USA | Convenience Sampling (CS) | Men Veterans | The Structured Clinical Interview for DSM-III-R (SCID-III-R) | 55 | 295 | 59 (22.8%) | 6 |
Kozaric-Kovacic, D. et al. (2001) (82) | Croatia | Random Sampling (CS) | Men Veterans | The Hamilton Depression Rating Scale (HAMD) | 34 | 249 | 77 (31%) | 7 |
Sayar, K. et al. (2001) (83) | Turkey | Random Sampling (CS) | Men Soldiers | (Beck Depression Inventory)BDI( | 22.7 | 40 | 13 (32.5%) | 7 |
Hunter, C. L.et al. (2002)(84) | USA | Random Sampling (CS) | Active Duty | The Patient Health Questionnaire (PHQ) (the self-report version of the PRIME-MD) | 54.15 | 337 | 19 (5.6%) | 7 |
Karel, M. J. et al. (2002)(85) | USA | Random Sampling (Survey Study) | Men Veterans | The Geriatric Depression Scale (GDS)- 15 item | 69.7 | 967 | 236 (24.4%) | 7 |
Hamilton Depression Rating Scale (HDRS)-24 item | 69.7 | 967 | 94 (9.7%) | |||||
Kilbourne, A. M. et al. (2002)(86) | USA | Random Sampling (CS) | Veterans with HIV infection | The 10-item Centers for Epidemiologic Studies Depression Scale (CES-D) | 49 | 881 | 405 (46%) | 7 |
Lehman, C. L. et al. (2002)(87) | USA | Convenience Sampling (CS) | Veterans with Hepatitis C | The Beck Depression Inventory (BDI) | 49 | 120 | 53 (44.2%) | 6 |
Muir, A. J. et al. (2002)(88) | USA | Convenience Sampling (CS) | Veterans with Hepatitis C | The Center for Epidemiological Studies Depression (CES-D) scale | 47.3 | 100 | 12 (12%) | 6 |
Nguyen, H. A. et al. (2002)(89) | USA | Convenience Sampling (CS) | Veterans with Hepatitis C | Clinical Symptoms (Interviews) | 46.5 | 118 | 73 (62%) | 6 |
Black, D. W. et al. (2004)(90) | USA | Convenience Sampling (CS) | Veterans | Clinical Symptoms (Interviews) DSM-III-R | 39.3 | 602 | 192 (32%) | 6 |
Gerson, S. et al. (2004) (91) | USA | Convenience Sampling (CS) | Elderly veterans (Male) | Mental Health Inventory (MHI) | 69.6 | 839 | 273 (32.5%) | 8 |
Rowan, P. J. et al. (2004)(92) | USA | Convenience Sampling (CS) | Veterans with Hepatitis C | The Zung Self-report Depression Scale (SDS) | 51 | 580 | 93 (16%) | 7 |
Smith, T. C. et al. (2004)(93) | USA | Random Sampling (CS) | US Military | The PRIME-MD Patient Health Questionnaire (PHQ) | 55 | 8893 | 1642 (18.5%) | 8 |
Vafaee, B.et al. (2004)(94) | Iran | Convenience Sampling (CS) | Disabled veterans male | The Zung Self-report Depression Scale (SDS) | 38 | 100 | 71 (71%) | 5 |
Forman-Hoffman, V. L. et al. (2005) (95) | USA | Convenience Sampling (CS) | Veterans | Structured Clinical Interview for DSM Disorders (SCID-IV) | 39.1 | 602 | 85 (14.11%) | 6 |
Goulet, J. L. et al. (2005)(96) | USA | Convenience Sampling (Re) | Veterans with HIV | – | 47.1 | 20,627 | 5776 (28%) | 7 |
Veterans with Hepatitis C | – | 46.9 | 4489 | 1975 (44%) | ||||
Rowan, P. J. et al. (2005)(97) | USA | Convenience Sampling (CS) | Veterans with Hepatitis C | The Beck Depression Inventory (BDI) | 52 | 62 | 6 (10%) | 5 |
Williams, R. M. et al. (2005)(98) | USA | Convenience Sampling (CS) | Veterans with Multiple sclerosis | The Beck Depression Inventory (BDI) | 55.1 | 451 | 100 (22.2%) | 7 |
Xiong, H. et al. (2005)(99) | China | Random Sampling (CS) | Young adult males during their 8 week field military training | The Zung Self-report Depression Scale (SDS) | 20 | 1107 | 279 (25.2%) | 6 |
Grieger, T. A. et al. (2006)(100) | USA | Convenience Sampling (CS) | U.S. soldiers were injured in combat | The nine-item Patient Health Questionnaire depression scale | 26.94 | 301 | 28 (9.3%) | 5 |
Hoge, C. W. et al. (2006)(101) | USA | Random Sampling (CS) | Army soldiers and Marines | The PRIME-MD Patient Health Questionnaire (PHQ) | 31.2 | 303,905 | 15,930 (5.24%) | 8 |
Kress, A. M. et al. (2006)(102) | USA | Random Sampling (CS) | U.S. Military personnel | Burnam Screen | – | 4227 | 844 (20%) | 8 |
Pflanz, S. E. et al. (2006)(103) | USA | Convenience Sampling (CS) | Military Personnel | Depression Checklist | 28.7 | 780 | 141 (18%) | 7 |
Dove, M. B. et al. (2007)(104) | USA | Convenience Sampling (CS) | Women Entering a Military Substance Use Disorder | Depression Checklist | – | 86 | 67 (78%) | 5 |
Kolkow, T. T. et al. (2007)(105) | USA | Convenience Sampling (CS) | Army soldiers | The PRIME-MD Patient Health Questionnaire (PHQ) | 34.30 | 100 | 5 (5%) | 5 |
Warner, C. M. et al. (2007)(106) | USA | Convenience Sampling (CS) | Military Personnel | The PRIME-MD Patient Health Questionnaire (PHQ) | 20.9 | 1090 | 173 (15.9%) | 6 |
Male | 20.9 | 955 | 143 (15%) | |||||
Female | 21 | 135 | 30 (22.2%) | |||||
Hoge, C. W. et al. (2008) (107) | USA | Convenience Sampling (CS) | Army individual | The PRIME-MD Patient Health Questionnaire (PHQ) | – | 1885 | 275 (15%) | 6 |
Marine individual | 775 | 114 (14.7%) | ||||||
Iversen, A. C. et al. (2009)(108) | UK | Random Sampling (CS) | UK military personnel in service at the time of the 2003 Iraq War | The PRIME-MD Patient Health Questionnaire (PHQ) | 35 | 821 | 223 (27.2%) | 8 |
Kline, A. et al. (2009)(109) | USA | Convenience Sampling (CS) | Vietnam veterans with Substance Use Disorder | SCID DSM-IV Diagnoses | 55.20 | 82 | 39 (47.9%) | 8 |
Post-Vietnam veterans with Substance Use Disorder | 46.76 | 236 | 131 (55.4%) | |||||
Persian Gulf veterans with Substance Use Disorder | 34 | 55 | 33 (59.5%) | |||||
Rehn, L. M. et al. (2009)(110) | Finland | Convenience Sampling (CS) | Male Finnish military conscripts | The Beck Depression Inventory (BDI) | 20 | 126 | 4 (3.2%) | 6 |
Rukskul, I. et al. (2009) (111) | Thailand | Convenience Sampling (CS) | Thai army personnel | Clinical Symptoms (Interviews) | 45 | 1729 | 186 (10.75%) | 5 |
Rukskul, I. (2010)(112) | Thailand | Convenience Sampling (CS) | Thai army personnel | Clinical Symptoms (Interviews) | 45 | 213 | 7 (3.3%) | 5 |
Fikretoglu, D. et al. (2010)(113) | Canada | Convenience Sampling (CS) | Canadian Community Health Survey-Canadian Forces KlineKline(CCHS-CF) | Diagnostic and Statistical Manual of Mental Disorders-IV (DSM-IV) | – | 8441 | 1257 (14.9%) | 8 |
Haskell, S. G. et al. (2010)(114) | USA | Convenience Sampling (CS) | War Veterans of Iraq and Afghanistan | Clinical Symptoms (Interviews) | 32 | Total (1229) | 472 (38.4%) | 7 |
32 | Male (1032) | 380 (36.8%) | ||||||
30 | Female (197) | 92 (46.7%) | ||||||
Luxton, D. D. et al. (2010)(115) | USA | Convenience Sampling (CS) | Active duty Soldiers between March 2006 and July 2009. | The PRIME-MD Patient Health Questionnaire (PHQ) | 27.37 | Total (6943) | 704 (10.1%) | 7 |
Male (6427) | 646 (10.0%) | |||||||
Female (516) | 58 (46.7%) | |||||||
Maguen, S. et al. (2010)(116) | USA | Convenience Sampling (CS) | Iraq and Afghanistan Veterans Enrolled in Veterans Affairs Health Care | Diagnostic and Statistical Manual of Mental Disorders-IV (DSM-IV) | 31.21 | Total (329049) | 57,051 (17.33%) | 8 |
31.47 | Male (288348) | 47,876 (17%) | ||||||
29.41 | Female (40701) | 9175 (23%) | ||||||
Stecker, T. et al. (2010)(117) | Lebanon | Convenience Sampling (CS) | Iraq/Afghanistan veterans | Diagnostic and Statistical Manual of Mental Disorders-IV (DSM-IV) | 34.4 | 293,861 | 36,900 (12.5%) | 6 |
Iraq/Afghanistan Veterans with Alcohol Use Disorder | 118,332 | 4568 (3.8%) | ||||||
Burnett-Zeigler, I. et al. (2011)(118) | USA | Random Sampling (CS) | Afghanistan and Iraq Veterans | The PRIME-MD Patient Health Questionnaire (PHQ) | – | 362 | 64 (17.6%) | 7 |
Iraq/Afghanistan Veterans with Alcohol Use Disorder | 200 | 72 (36%) | ||||||
Erbes, C. R. et al. (2011)(119) | USA | Convenience Sampling (CS) | National Guard/Reserve veterans returning from Iraq | The Beck Depression Inventory (BDI) | 31.60 | 617 | 83 (13.5%) | 7 |
Guerra, V. S. et al. (2011)(120) | USA | Convenience Sampling (CS) | Veterans in Operations Enduring Freedom and Iraqi Freedom (OEF/OIF) | The Beck Depression Inventory (BDI) Beck Scale for Suicide Ideation Scale for Suicide Ideation-Adapted | 38.3 | 393 | 88 (22.4%) | 8 |
Jakupcak, M. et al. (2011)(121) | USA | Convenience Sampling (CS) | Iraq and Afghanistan War Veterans in the U.S | The PRIME-MD Patient Health Questionnaire (PHQ) | 31 | 336 | 126 (37.5%) | 7 |
Kehle, S. M. et al. (2011)(122) | USA | Convenience Sampling (CS) | Soldiers from a National Guard Brigade Combat Team (BCT) | Diagnostic and Statistical Manual of Mental Disorders-IV (DSM-IV) | 31.30 | Total (348) | 51 (15%) | 7 |
Male (304) | 39 (13%) | |||||||
Female (44) | 12 (27%) | |||||||
Alcohol use disorders | 348 | 45 (13%) | ||||||
Substance use disorders | 348 | 4 (1%) | ||||||
Garber, B. G. et al. (2012)(123) | Canada | Convenience Sampling (CS) | Canadian Forces Members While on Deployment to Afghanistan | The PRIME-MD Patient Health Questionnaire (PHQ) | – | 1572 | 73 (4.7%) | 5 |
Maguen, S. et al. (2012)(124) | USA | Convenience Sampling (Re) | Iraq and Afghanistan Veterans | The Diagnostic and Statistical Manual-Fourth Edition (DSM-IV) | 45 | Total (74493) | 41,424 (56%) | 7 |
Male (67238) | 36,359 (54%) | |||||||
Female (7255) | 5065 (70%) | |||||||
Vasterling, J. J. et al. (2012)(125) | USA | Convenience Sampling (CS) | Iraq-deployed US Army soldiers | The Center for Epidemiological Studies Depression Scale (CES-D) | 25.1 | 760 | 238 (31.3%) | 7 |
Cohen, S. I. et al. (2013)(126) | USA | Convenience Sampling (CS) | US military veterans returning from Iraq and Afghanistan | The Diagnostic and Statistical Manual-Fourth Edition (DSM-IV) | – | 93 | 44 (47.3%) | 6 |
Harbertson, J. et al. (2013)(127) | USA | Convenience Sampling (CS) | Male Rwanda Defense Forces military personnel | The Center for Epidemiological Studies Depression Scale (CES-D) | 30.9 | 1238 | 232 (22.1%) | 7 |
546 | 129 (23.7%) | |||||||
Alcohol Use Disorder | ||||||||
Marshall, B. D. et al. (2013)(128) | USA | Convenience Sampling (CS) | Ohio Army National Guard Soldiers | The PRIME-MD Patient Health Questionnaire (PHQ) | – | 2117 | 128 (6%) | 7 |
142 | 17 (12%) | |||||||
Soldiers with HIV | ||||||||
Morrow, C. E. et al. (2013)(129) | USA | Convenience Sampling (CS) | U.S. Air Force | The PRIME-MD Patient Health Questionnaire (PHQ) | 30.35 | 194 | 3 (1.6%) | 5 |
Swinkels, C. M. et al. (2013)(130) | UK | Convenience Sampling (CS) | U.S. Afghanistan/Iraq Veterans | Diagnostic and Statistical Manual of Mental Disorders-IV (DSM-IV) | 37.40 | 1640 | 308 (18.8%) | 6 |
Chapman, P. L. et al. (2014)(131) | USA | Convenience Sampling (CS) | U.S. Army Combat Medics | The PRIME-MD Patient HealthQuestionnaire (PHQ) | 43.54 | 543 | 73 (13.4%) | 6 |
Clarke-Walper, K. et al. (2014)(132) | USA | Convenience Sampling (CS) | Soldiers who returned from Iraq or Afghanistan | The PRIME-MD Patient Health Questionnaire (PHQ) | – | 7849 | 611 (8.1%) | 7 |
2328 | 304 (13.1%) | |||||||
Alcohol use | ||||||||
Curry, J. F. et al. (2014)(133) | USA | Convenience Sampling (CS) | Veterans | Diagnostic and Statistical Manual of Mental Disorders-IV (DSM-IV) | 37.48 | Total (1700) | 652 (38.4%) | 7 |
Male (1354) | 491 (36.3%) | |||||||
Female (346) | 161 (46.5%) | |||||||
Veterans with alcohol use | 623 | 72 (11.6%) | ||||||
Veterans with substance use | 154 | 7 (4.5%) | ||||||
Denneson, L. M. et al. (2014)(134) | USA | Convenience Sampling (CS) | Iraq and Afghanistan Veterans | The PRIME-MD Patient Health Questionnaire (PHQ) | – | 465 | 237 (51%) | 7 |
Don Richardson, J. et al. (2014)(135) | Canada | Convenience Sampling (CS) | Canadian Forces members and veterans | The PRIME-MD Patient Health Questionnaire (PHQ) | – | 404 | 316 (78.2%) | 7 |
Garber, B. G. et al. (2014)(136) | Canada | Random Sampling (CS) | Canadian armed forces personnel | The PRIME-MD Patient Health Questionnaire (PHQ) | – | 16,153 | 593 (3.67%) | 8 |
Heltemes, K. J. et al. (2014)(137) | USA | Random Sampling (CS) | Injured veterans | Diagnostic and Statistical Manual of Mental Disorders-IV (DSM-IV) | 22.5 | 812 | 146 (18%) | 6 |
Lehavot, K. et al. (2014)(138) | USA | Random Sampling (CS) | Sexual Minority and Heterosexual Women Veterans | The PRIME-MD Patient Health Questionnaire (PHQ) | 48 | 697 | 260 (37.3%) | 7 |
Ramsawh, H. J. et al. (2014)(139) | USA | Convenience Sampling (CS) | Active Duty Military Personnel | 10-item Center for Epidemiologic Studies Depression Scale | 35 | 5461 | 1914 (35%) | 8 |
Bin Zubair, U. et al. (2015)(140) | Pakistan | Random Sampling (CS) | All military recruits were men and above the age of 17 years. | The Beck Depression Inventory (BDI) | 20 | 313 | 159 (50.7%) | 7 |
Cleveland, S. D. et al. (2015)(141) | USA | Convenience Sampling (CS) | Veterans and Civilian College Students | Diagnostic and Statistical Manual of Mental Disorders-IV (DSM-IV) | – | 26,969 | 7982 (30.17%) | 8 |
Foote, C. E. et al. (2015)(142) | USA | Random Sampling (CS) | Vietnam veterans | The PRIME-MD Patient Health Questionnaire (PHQ) | – | 247 | 44 (17.8%) | 7 |
Hamilton, A. B. et al. (2015) (143) | USA | Random Sampling (CS) | Employed Women Veterans | The five-question Mental Health Inventory (MHI-5) | – | 1410 | 120 (4.1%) | 7 |
195 | 42 (27.3%) | |||||||
Unemployed Women Veterans | ||||||||
Hoerster, K. D. et al. (2015)(144) | USA | Random Sampling (CS) | Iraq and Afghanistan veterans | The PRIME-MD Patient Health Questionnaire (PHQ) | 31.3 | 332 | 53 (16.3%) | 7 |
Kim, N. Y. et al. (2015) (145) | USA | Convenience Sampling (CS) | Korean Soldiers | Scale for suicide ideation (SSI), The Beck Depression Inventory (BDI) | 21.3 | 414 | 21 (5%) | 6 |
Lundin, A. et al. (2015)(146) | Sweden | Random Sampling (CS) | Vietnam veterans | Diagnostic and Statistical Manual of Mental Disorders-IV (DSM-IV) | – | 4251 | 1263 (29.7%) | 7 |
McGuire, A. et al. (2015)(147) | UK | Random Sampling (CS) | Australian Defense Force (ADF men) | Diagnostic and Statistical Manual of Mental Disorders-IV (DSM-IV) | 50 | 4091 | 454(11%) | 7 |
Department of Veterans’ Affairs (DVA women) | 4761 | 869 (18.3%) | ||||||
Mysliwiec, V. et al. (2015)(148) | USA | Convenience Sampling (CS) | U.S. Military Personnel | Quick Inventory of Depressive Symptomatology (QIDS) | 36.2 | 58 | 30 (51.7%) | 7 |
Nasioudis, D. et al. (2015)(149) | Greece | Random Sampling (CS) | Greek military medicine cadets | The Zung Self-report Depression Scale (SDS) | 19.84 | Total (146) | 57 (39%) | 7 |
Male (91) | 36 (39.5%) | |||||||
Female (55) | 21 (38.2%) | |||||||
Vanderploeg, R. D. et al. (2015) (150) | USA | Convenience Sampling (CS) | Florida National Guard Members | The PRIME-MD Patient Health Questionnaire (PHQ) | – | 3098 | 63 (2%) | 7 |
Fink, D. S. et al. (2016) (151) | USA | Convenience Sampling (CS) | U.S. Army National Guard soldiers | Diagnostic and Statistical Manual of Mental Disorders-IV (DSM-IV) | 44 | 671 | 154 (23%) | 8 |
Forbes, D. et al. (2016)(152) | Australia | Convenience Sampling (CS) | Australian peacekeepers | Diagnostic and Statistical Manual of Mental Disorders-IV (DSM-IV) | 46.5 | 2050 | 201 (9.8%) | 8 |
Guloglu, B. et al. (2016)(153) | Turkey | Convenience Sampling (CS) | Turkish combat-injurednon-professional veterans | The Brief Symptom Inventory (BSI) | 40 | 336 | 55 (16.4%) | 7 |
Hardos, J. E. et al. (2016) (154) | USA | Convenience Sampling (CS) | Aircraft Maintenance Workers | The PRIME-MD Patient Health Questionnaire (PHQ) | 29 | 4801 | 1042 (21.7%) | 7 |
Herberman Mash, H. B. et al. (2016)(155) | USA | Convenience Sampling (CS) | U.S. Army soldiers | The 10-item Center for Epidemiologic Studies Depression Scale | – | 3813 | 1368 (35.8%) | 8 |
U.S. Army soldiers with alcohol use | 1210 | 583 (48.18%) | ||||||
Monteith, L. L. et al. (2016)(156) | USA | Convenience Sampling (CS) | Veterans | Beck Scale for Suicide Ideation (BSS), Multidimensional Suicide Inventory-28 (MSI) Negative Affect scale | 49.6 | Total (354) | 169 (47.7%) | 8 |
Male (310) | 146 (47.1%) | |||||||
Female (44) | 32 (52.3%) | |||||||
Phillips, K. M. et al. (2016)(157) | USA | Convenience Sampling (CS) | Iraq- and Afghanistan-era Veterans | 20-item, self-report Center for Epidemiological Studies Depression Scale (CES-D) | 35.1 | 359 | 108 (30%) | 6 |
Zamorski, M. A. et al. (2016)(158) | Canada | Convenience Sampling (CS) | Canadian Armed Forces | Diagnostic and Statistical Manual of Mental Disorders-IV (DSM-IV) | – | 5120 | 410 (8%) | 7 |
Boakye, E. A. et al. (2017)(159) | USA | Random Sampling (CS) | Veterans | Self-Report | 40 | 144 | 48 (33.3%) | 7 |
Veterans with alcohol use | 75 | 24 (32%) | ||||||
Cohen, G. H. et al. (2017)(160) | USA | Convenience Sampling (CS) | Army National Guard Soldiers | The PRIME-MD Patient Health Questionnaire (PHQ), The PHQ-9 Item | – | 1582 | 164 (10.3%) | 8 |
Army National with Alcohol Use | 93 | 27 (29%) | ||||||
Gradus, J. L. et al. (2017)(161) | USA | Random Sampling (CS) | Veterans of the Iraq and Afghanistan Wars | 20-item, self-report Center for Epidemiological Studies Depression Scale (CES-D), The 4-item Suicidal Behaviors Questionnaire-Short Form (SBQ-SF) | 34 | Total (2244) | 712 (31.7%) | 7 |
Male (1062) | 314 (29.5%) | |||||||
Female (1099) | 398 (36.3%) | |||||||
Packnett, E. R. et al. (2017)(162) | USA | Convenience Sampling (CS) | Army | Diagnostic and Statistical Manual of Mental Disorders-IV (DSM-IV) | – | 34,487 | 1777 (5.1%) | 8 |
Navy | 6602 | 263 (4%) | ||||||
Marine Corps | 8428 | 113 (1.3%) | ||||||
Air Force | 9510 | 729 (7.6%) | ||||||
Weeks, M. et al. (2017)(163) | Canada | Convenience Sampling (CS) | Canadian Military and Civilian Populations | Diagnostic and Statistical Manual of Mental Disorders-IV (DSM-IV) | 35 | 6696 | 536 (8%) | 8 |
Bartlett, B. A. et al. (2018)(164) | USA | Convenience Sampling (CS) | Military veterans | 20-item, self-report Center for Epidemiological Studies Depression Scale (CES-D) | 38.40 | 910 | 75 (9.8%) | 6 |
Blakey, S. M. et al. (2018)(165) | USA | Convenience Sampling (CS) | U.S. veterans, active duty personnel, and National Guard and Reserve members | Diagnostic and Statistical Manual of Mental Disorders-IV (DSM-IV) | 37.8 | 667 | 169 (25.3%) | 7 |
Boulos, D. et al. (2018)(166) | Canada | Random Sampling (CS) | Regular Force personnel | Diagnostic and Statistical Manual of Mental Disorders-IV (DSM-IV) | – | 3385 | 129 (3.8%) | 7 |
Reserve Force personnel | 1469 | 55 (3.7%) | ||||||
Dillon, K. H. et al. (2018)(167) | USA | Convenience Sampling (CS) | Iraq/Afghanistan-era veterans | The Beck Scale for Suicide Ideation (BSS), The Structured Clinical Interview for DSM-IV-TR (SCID) | – | 3238 | 1315 (40.6%) | 7 |
Don Richardson, J. et al. (2018)(168) | Canada | Convenience Sampling (CS) | Canadian Armed Forces members and veterans | The PRIME-MD Patient Health Questionnaire (PHQ) | 44.6 | 522 | 413 (79.1%) | 7 |
Elbogen, E. B. et al. (2018)(169) | USA | Convenience Sampling (CS) | Iraq/Afghanistan-era veterans | Diagnostic and Statistical Manual of Mental Disorders-IV (DSM-IV) | 34.9 | 1172 | 375 (32%) | 6 |
Hourani, L. L. et al. (2018)(170) | USA | Convenience Sampling (CS) | Active duty military personnel | The PRIME-MD Patient Health Questionnaire (PHQ), Checklist | – | 947 | 115 (15.4%) | 7 |
Kizilhan, J. I. et al. (2018)(171) | Iraq | Convenience Sampling (CS) | Child soldiers | Diagnostic and Statistical Manual of Mental Disorders-IV (DSM-IV) | 12.6 | 81 | 37 (45.6%) | 6 |
McDonald, S. D. et al. (2018)(172) | USA | Convenience Sampling (CS) | U.S. Department of Veterans Affairs outpatients | Diagnostic and Statistical Manual of Mental Disorders-IV (DSM-IV) | 58.1 | 280 | 53 (19%) | 7 |
Stefanovics, E. A. et al. (2018)(173) | USA | Convenience Sampling (CS) | US Veterans | The Patient Health Questionnaire-4 | 59 | 3122 | 209 (6.7%) | 7 |
Vun, E. et al. (2018)(174) | Canada | Convenience Sampling (CS) | Canadian Armed Forces active personnel | Diagnostic and Statistical Manual of Mental Disorders-IV (DSM-IV) | 35.4 | 6696 | 517 (8%) | 8 |
Waitzkin, H. et al. (2018)(175) | USA | Convenience Sampling (CS) | Military Personnel | The PRIME-MD Patient Health Questionnaire (PHQ) | – | 198 | 143 (72%) | 7 |
Byrne, S. P. et al. (2019)(176) | USA | Convenience Sampling (CS) | U.S. military veterans | The PRIME-MD Patient Health Questionnaire (PHQ) | 53.4 | 158 | 62 (34.7%) | 7 |
Carney, B. et al. (2019)(177) | USA | Random Sampling (CS) | US Military population with HIV infection | 20- item, self-report Center for Epidemiological Studies Depression Scale (CES-D) | 32 | 662 | 114 (17.2%) | 8 |
Jones, N. et al. (2019)(178) | UK | Random Sampling (CS) | UK Armed Forces | The PRIME-MD Patient Health Questionnaire (PHQ) | – | Total (1448) | 110 (7.6%) | 6 |
Male (1229) | 93 (7.7%) | |||||||
Female (219) | 17 (7.9%) | |||||||
Lucas, C. L. et al. (2019)(179) | USA | Convenience Sampling (CS) | Military Personnel | The PRIME-MD Patient Health Questionnaire (PHQ) | – | Total (1980) | 660 (37.9%) | 7 |
Male (1665) | 530 (36.2%) | |||||||
Female (315) | 130 (46.8%) | |||||||
Nichter, B. et al. (2019)(180) | USA | Random Sampling (CS) | U.S. veteran population | The Patient Health Questionnaire-4 (PHQ-4), The Patient Health Questionnaire-9 (PHQ-9) | 60.3 | 2732 | 201 (7.3%) | 9 |
Start, A. R. et al. (2019)(181) | USA | Convenience Sampling (CS) | Military Personnel | The Patient Health Questionnaire-9 (PHQ-9) | – | 944 | 72 (7.6%) | 7 |
Blosnich, J. R. et al. (2020)(182) | USA | Random Sampling (CS) | Military Veterans | Diagnostic and Statistical Manual of Mental Disorders-IV (DSM-IV) | – | 293,872 | 45,391 (15.4%) | 9 |
Forys-Donahue, K. L. et al. (2020)(183) | USA | Random Sampling (CS) | US Army population | The Patient Health Questionnaire-9 (PHQ-9) | – | 7043 | 774 (11%) | 6 |
Gjerstad, C. L. et al. (2020)(184) | Norway | Convenience Sampling (CS) | Norwegian Peacekeepers | The Hospital Anxiety and Depression Scale (HADS) | 30 | 10,450 | 417 (4%) | 8 |
Groll, D. L. et al. (2020)(185) | Canada | Convenience Sampling (CS) | Canadian military persons | The Patient Health Questionnaire-9 (PHQ-9) | – | 477 | 61 (12.8%) | 8 |
Gross, G. M. et al. (2020)(186) | USA | Random Sampling (CS) | U.S. veteran population | The Patient Health Questionnaire-9 (PHQ-9) | 35 | Total (650) | 306 (47%) | 7 |
Male (498) | 192 (38.6%) | |||||||
Female (352) | 114 (32.4%) | |||||||
Shim, E. J. et al. (2020)(187) | Korea | Random Sampling (CS) | Korean military population | The Mini International Neuropsychiatric Interview Plus (MINI-Plus), The Patient Health Questionnaire-9 (PHQ-9) | 50.6 | 1937 | 162 (8.4%) | 8 |
Smigelsky, M. A. et al. (2020)(188) | USA | Convenience Sampling (CS) | U.S. military population | Diagnostic and Statistical Manual of Mental Disorders-IV (DSM-IV) | 37.6 | 1002 | 210 (21%) | 6 |
Smith, L. M. et al. (2020)(189) | USA | Convenience Sampling (CS) | U.S. Air Force Basic Military Training | The Patient Health Questionnaire-9 (PHQ-9) | – | 85 | 20 (23.5%) | 5 |
Stefanovics, E. A. et al. (2020)(190) | USA | Convenience Sampling (CS) | U.S. Military Veterans | The Mini International Neuropsychiatric Interview (MINI), The Patient Health Questionnaire-9 (PHQ-9) | 55 | 1308 | 340 (30%) | 5 |
Taillieu, T. L. et al. (2020)(191) | Canada | Convenience Sampling (CS) | Canadian Armed Forces | Diagnostic and Statistical Manual of Mental Disorders-IV (DSM-IV) | – | 6447 | 1006(15.6%) | 5 |
Wang, J. et al. (2020)(192) | USA | Convenience Sampling (CS) | U.S. Reserve and National Guard Personnel | The Patient Health Questionnaire-9 (PHQ-9) | 34.4 | 3503 | 86 (2.5%) | 6 |
Ursano, R. J. et al. (2020)(193) | USA | Convenience Sampling (CS) | US Army Soldiers During Deployment in Afghanistan | Diagnostic and Statistical Manual of Mental Disorders-IV (DSM-IV) | – | 3957 | 173 (4.1%) | 7 |
Yeom, C. W. et al. (2020)(194) | Korea | Convenience Sampling (CS) | Korean military personal | The Mini International Neuropsychiatric Interview Plus (MINI-Plus Suicidality module), The Patient Health Questionnaire-9 (PHQ-9) | 21.4 | 480 | 27(5.6%) | 6 |
Authors (Years) | Country | Type of Sampling (Type of Study) | Study Population | Depression Assessment Method | Age (Mean) | Sample size | Prevalence of Suicide (%) | NOS Score | |
---|---|---|---|---|---|---|---|---|---|
Attempts | Thoughts | ||||||||
Helzer, J. E. et al. (1976) (66) | USA | Random Sampling (CS) | Army men | Clinical Symptoms (Interviews) | – | 470 | NR | 42 (9%) | 7 |
Bohnker, B. et al. (1992) (195) | USA | Random Sampling (CS) | Aircraft Carrier (men) | NR | – | 150 | 102 (68%) | NR | 6 |
Brown, G. R. et al. (1993) (70) | USA | Random Sampling (CS) | Air Forces men with HIV | Structured Interview Guide for the Hamilton Anxiety and Depression Scales (SIGH-AD) | 35 | 442 | 24 (5.4%) | NR | 8 |
Lish, J. D. et al. (1996) (74) | USA | Random Sampling (CS) | Army men and women | Brief self-report questionnaire (SCRENNER) | 21.2 | 669 | NR | 51 (7.62%) | 7 |
Benda, B. B. (2003) (196) | USA | Convenience Sampling (CS) | Veterans Who Abuse Substances | Multi-Problem Screening Inventory (MPSI) | 50.3 | 600 | 240 (40%) | 184 (30.7%) | 7 |
Ritchie, E. C. et al. (2003)(197) | USA | Convenience Sampling (CS) | Men and Women in the Navy and Marine Corps | – | 43 | 100 | 54 (54%) | NR | 5 |
Benda, B. B. et al. (2005)(198) | USA | Convenience Sampling (CS) | Veterans Who Abuse Substances | The Multi-Problem Screening Inventory (MPSI) | 40.3 | 625 | 197 (31.5%) | 291 (46.5%) | 6 |
Hoge, C. W. et al. (2006)(101) | USA | Random Sampling (CS) | Army soldiers and Marines | The PRIME-MD Patient Health Questionnaire (PHQ) | 31.2 | 303,905 | NR | 3501 (1.15%) | 8 |
Dove, M. B. et al. (2007)(104) | USA | Convenience Sampling (CS) | Women Entering a Military Substance Use Disorder | Depression Checklist | – | 86 | NR | 15 (17.4%) | 5 |
Kline, A. et al. (2009)(109) | USA | Convenience Sampling (CS) | Vietnam veterans with Substance Use Disorder | SCID DSM-IV Diagnoses | 55.20 | 82 | 23 (27.8%) | 5 (6.1%) | 8 |
Post-Vietnam veterans with Substance Use Disorder | 46.76 | 236 | 63 (26.8%) | 16 (6.8%) | |||||
Persian Gulf veterans with Substance Use Disorder | 34 | 55 | 9 (15.4%) | 5 (9.1%) | |||||
Rehn, L. M. et al. (2009)(110) | Finland | Convenience Sampling (CS) | Male Finnish military conscripts | The Beck Depression Inventory (BDI) | 20 | 126 | NR | 9 (7.1%) | 6 |
Belik, S. L. et al. (2010)(199) | Canada | Convenience Sampling (CS) | The Canadian Forces | Diagnostic and Statistical Manual of Mental Disorders-IV (DSM-IV) | – | 37,129 | 236 (0.8%) | 1613 (4.34%) | 8 |
Guerra, V. S. et al. (2011)(120) | USA | Convenience Sampling (CS) | Veterans in Operations Enduring Freedom and Iraqi Freedom (OEF/OIF) | The Beck Depression Inventory (BDI) Beck Scale for Suicide Ideation Scale for Suicide Ideation-Adapted | 38.3 | 393 | 34 (8.7%) | 45 (11.5%) | 8 |
Mansfield, A. J. et al. (2011)(200) | USA | Convenience Sampling (CS) | Military Personnel | The Center for Epidemiological Studies Depression (CES-D) scale, The PRIME-MD Patient Health Questionnaire (PHQ) | 28.1 | 3069 | NR | 215 (7%) | 6 |
Military Personnel (Navy) | 31.8 | 1843 | 98 (5.3%) | ||||||
25.8 | 1226 | 110 (9%) | |||||||
Military Personnel (Marine) | |||||||||
Female (7255) | |||||||||
Maguen, S. et al. (2012)(201) | USA | Convenience Sampling (CS) | Vietnam veterans | Checklist | 40 | 244 | 12 (4.9%) | 40 (16.4%) | 6 |
Swinkels, C. M. et al. (2013)(130) | UK | Convenience Sampling (CS) | U.S. Afghanistan/Iraq Veterans | Diagnostic and Statistical Manual of Mental Disorders-IV (DSM-IV) | 37.40 | 1640 | 132 (8%) | NR | 6 |
Bryan, C. J. et al. (2013)(202) | USA | Convenience Sampling (CS) | Deployed Military Personnel | The 4-item Suicidal Behaviors Questionnaire– Revised (SBQ-R) | – | 161 | NR | 35 (21.7%) | 5 |
Bryan, C. J. et al. (2013)(203) | USA | Convenience Sampling (CS) | Deployed Military Personnel | The 4-item Suicidal Behaviors Questionnaire– Revised (SBQ-R) | – | 158 | 3 (1.5%) | 21 (13.1%) | 5 |
Bryan, C. J. et al. (2013)(204) | USA | Convenience Sampling (CS) | Air Force Personnel | Beck Scale for Suicidal Ideation-Current (BSSI-C) | 25.9 | 273 | NR | 53 (19.4%) | 5 |
Bryan, C. J. et al. (2013)(205) | USA | Convenience Sampling (CS) | Deployed Military Personnel | The Self-Injurious Thoughts and Behaviors Interview (SITBI) | 34.2 | 69 | NR | 25 (36.2%) | 5 |
Blosnich, J. R. et al. (2014)(206) | USA | Convenience Sampling (CS) | Deployed Military Personnel | Checklist | – | 4250 | NR | 154 (3.3%) | 5 |
Bryan, C. J. et al. (2014)(207) | USA | Convenience Sampling (CS) | Deployed Military Personnel | The Self-Injurious Thoughts and Behaviors Interview (SITBI) | 36.7 | 374 | 29 (7.8%) | 136 (36.4%) | 6 |
Mash, H. B. et al. (2014)(208) | USA | Convenience Sampling (CS) | US Army | Checklist | – | 4999 | NR | 303(6%) | 6 |
Don Richardson, J. et al. (2014)(135) | Canada | Convenience Sampling (CS) | Canadian Forces members and veterans | The PRIME-MD Patient Health Questionnaire (PHQ) | – | 404 | NR | 68 (16.8%) | 7 |
Ramsawh, H. J. et al. (2014)(139) | USA | Convenience Sampling (CS) | Active Duty Military Personnel | 10-item Center for Epidemiologic Studies Depression Scale | 35 | 5461 | 346 (6.33%) | NR | 8 |
Bryan, C. J. et al. (2015)(209) | USA | Convenience Sampling (CS) | Air Force personnel | The Suicidal Behaviors Questionnaire Revised (SBQ-R) | – | 168 | 2 (1.2%) | 29 (17.3%) | 7 |
Cleveland, S. D. et al. (2015)(141) | USA | Convenience Sampling (CS) | Veterans and Civilian College Students | Diagnostic and Statistical Manual of Mental Disorders-IV (DSM-IV) | – | 26,969 | 282 (1.07%) | 1730 (6.54%) | 8 |
Kim, N. Y. et al. (2015) (145) | USA | Convenience Sampling (CS) | Korean Soldiers | Scale for suicide ideation (SSI), The Beck Depression Inventory (BDI) | 21.3 | 414 | NR | 80 (19.3%) | 6 |
Ursano, R. J. et al. (2015)(210) | USA | Convenience Sampling (CS) | Soldiers | The Columbia Suicidal Severity Rating Scale (C-SSRS) | 20 | 38,237 | 536 (1.9%) | 5353 (14%) | 8 |
Vanderploeg, R. D. et al. (2015) (150) | USA | Convenience Sampling (CS) | Florida National Guard Members | The PRIME-MD Patient Health Questionnaire (PHQ) | – | 3098 | NR | 130 (4.2%) | 7 |
Forbes, D. et al. (2016)(152) | Australia | Convenience Sampling (CS) | Australian peacekeepers | Diagnostic and Statistical Manual of Mental Disorders-IV (DSM-IV) | 46.5 | 2050 | 25 (1.2%) | 275 (13.4%) | 8 |
Herberman Mash, H. B. et al. (2016)(155) | USA | Convenience Sampling (CS) | U.S. Army soldiers | The 10-item Center for Epidemiologic Studies Depression Scale | – | 3813 | 230 (6%) | NR | 8 |
U.S. Army soldiers with alcohol use | 1210 | 100 (8.3%) | |||||||
Monteith, L. L. et al. (2016)(156) | USA | Convenience Sampling (CS) | Veterans | Beck Scale for Suicide Ideation (BSS), Multidimensional Suicide Inventory-28 (MSI) Negative Affect scale | 49.6 | Total (354) | 92 (26.8%) | NR | 8 |
Male (310) | 82 (26.5%) | ||||||||
Female (44) | 13 (29.5%) | ||||||||
Cohen, G. H. et al. (2017)(160) | USA | Convenience Sampling (CS) | Army National Guard Soldiers | The PRIME-MD Patient Health Questionnaire (PHQ), The PHQ-9 Item | – | 1582 | NR | 42 (2.6%) | 8 |
Army National with Alcohol Use | 93 | 8 (8.6%) | |||||||
Gradus, J. L. et al. (2017)(161) | USA | Random Sampling (CS) | Veterans of the Iraq and Afghanistan Wars | 20- item, self-report Center for Epidemiological Studies Depression Scale (CES-D), The 4-item Suicidal Behaviors Questionnaire-Short Form (SBQ-SF) | 34 | Total (2244) | NR | 370 (16.5%) | 7 |
Male (1062) | 179 (16.9%) | ||||||||
Female (1099) | 191 (17.4%) | ||||||||
Weeks, M. et al. (2017)(163) | Canada | Convenience Sampling (CS) | Canadian Military and Civilian Populations | Diagnostic and Statistical Manual of Mental Disorders-IV (DSM-IV) | 35 | 6696 | NR | 289 (4. %) | 8 |
Bartlett, B. A. et al. (2018)(164) | USA | Convenience Sampling (CS) | Military veterans | 20- item, self-report Center for Epidemiological Studies Depression Scale (CES-D) | 38.40 | 910 | 62 (7.5%) | NR | 6 |
Boulos, D. et al. (2018)(166) | Canada | Random Sampling (CS) | Regular Force personnel | Diagnostic and Statistical Manual of Mental Disorders-IV (DSM-IV) | – | 3385 | NR | 156 (4.6%) | 7 |
Reserve Force personnel | 1469 | 82 (5.6%) | |||||||
Dillon, K. H. et al. (2018)(167) | USA | Convenience Sampling (CS) | Iraq/Afghanistan-era veterans | The Beck Scale for Suicide Ideation (BSS), The Structured Clinical Interview for DSM-IV-TR (SCID) | – | 3238 | 291 (9%) | NR | 7 |
Elbogen, E. B. et al. (2018)(169) | USA | Convenience Sampling (CS) | Iraq/Afghanistan-era veterans | Diagnostic and Statistical Manual of Mental Disorders-IV (DSM-IV) | 34.9 | 1172 | 87 (7.5%) | NR | 6 |
Hourani, L. L. et al. (2018)(170) | USA | Convenience Sampling (CS) | Active duty military personnel | The PRIME-MD Patient Health Questionnaire (PHQ), Checklist | – | 947 | 16 (2.1%) | 71 (9.2%) | 7 |
Kachadourian, L. K. et al. (2018)(211) | USA | Convenience Sampling (CS) | Veterans | The Columbia-Suicide Severity Rating Scale (C-SSRS) | 43.9 | 93 | 19 (21.6%) | NR | 6 |
Kerr, K. et al. (2018)(212) | Australia | Convenience Sampling (CS) | Australian veterans | Checklist | 54.6 | 229 | 54 (23.6%) | NR | 6 |
Waitzkin, H. et al. (2018)(175) | USA | Convenience Sampling (CS) | Military Personnel | The PRIME-MD Patient Health Questionnaire (PHQ) | – | 198 | NR | 92 (48%) | 7 |
Byrne, S. P. et al. (2019)(176) | USA | Convenience Sampling (CS) | U.S. military veterans | The PRIME-MD Patient Health Questionnaire (PHQ) | 53.4 | 158 | 40 (24.4%) | 39 (30.2%) | 7 |
Nichter, B. et al. (2019)(180) | USA | Random Sampling (CS) | U.S. veteran population | The Patient Health Questionnaire-4 (PHQ-4), The Patient Health Questionnaire-9 (PHQ-9) | 60.3 | 2732 | 134 (4.9%) | 248 (9%) | 9 |
Start, A. R. et al. (2019)(181) | USA | Convenience Sampling (CS) | Military Personnel | The Patient Health Questionnaire-9 (PHQ-9) | – | 944 | NR | 31 (3.3%) | 7 |
Blosnich, J. R. et al. (2020)(182) | USA | Random Sampling (CS) | Military Veterans | Diagnostic and Statistical Manual of Mental Disorders-IV (DSM-IV) | – | 293,872 | 1035 (0.3%) | 2999 (1%) | 9 |
Cramer, R. J. et al. (2020)(213) | USA | Random Sampling (CS) | Military Personnel | The Suicide Behaviors Questionnaire-Revised (SBQ-R) | – | 200 | 96 (48%) | NR | 6 |
Groll, D. L. et al. (2020)(185) | Canada | Convenience Sampling (CS) | Canadian military persons | The Patient Health Questionnaire-9 (PHQ-9) | – | 477 | 19 (4%) | 76 (16%) | 8 |
Shim, E. J. et al. (2020)(187) | Korea | Random Sampling (CS) | Korean military population | The Mini International Neuropsychiatric Interview Plus (MINI-Plus), The Patient Health Questionnaire-9 (PHQ-9) | 50.6 | 1937 | 87 (4.5%) | NR | 8 |
Smigelsky, M. A. et al. (2020)(188) | USA | Convenience Sampling (CS) | U.S. military population | Diagnostic and Statistical Manual of Mental Disorders-IV (DSM-IV) | 37.6 | 1002 | 41 (4%) | NR | 6 |
Stefanovics, E. A. et al. (2020)(190) | USA | Convenience Sampling (CS) | U.S. Military Veterans | The Mini International Neuropsychiatric Interview (MINI), The Patient Health Questionnaire-9 (PHQ-9) | 55 | 1308 | 118 (9%) | 165(12.6%) | 5 |
Wang, J. et al. (2020)(192) | USA | Convenience Sampling (CS) | U.S. Reserve and National Guard Personnel | The Patient Health Questionnaire-9 (PHQ-9) | 34.4 | 3503 | NR | 101 (2.9%) | 6 |
Anestis, M. D. et al. (2020)(214) | USA | Convenience Sampling (CS) | U.S. Military Veterans | The Suicide Behaviors Questionnaire-Revised (SBQ-R) | 27.0 | 953 | NR | 105 (15.2%) | 5 |
Monteith, L. L. et al. (2020)(215) | USA | Convenience Sampling (CS) | Female veterans | Checklist | 55.6 | 439 | 158(36%) | 113(25.7%) | 5 |
Ursano, R. J. et al. (2020)(193) | USA | Convenience Sampling (CS) | US Army Soldiers During Deployment in Afghanistan | Diagnostic and Statistical Manual of Mental Disorders-IV (DSM-IV) | – | 3957 | NR | 85 (2.1%) | 7 |
Yeom, C. W. et al. (2020)(194) | Korea | Convenience Sampling (CS) | Korean military personal | The Mini International Neuropsychiatric Interview Plus (MINI-Plus Suicidality module), The Patient Health Questionnaire-9 (PHQ-9) | 21.4 | 480 | 22(4.5%) | NR | 6 |
Quantitative analysis
Prevalence of depression in the all military
Prevalence of depression in the active duty military
Categories | No. of Studies (Sample Size) | Pooled Prevalence (% 95 CI) | Between studies heterogeneity assessment (%) | Between subgroups heterogeneity assessment (%) | |||
---|---|---|---|---|---|---|---|
I2 | PHeterogenity | Z | Q | PHeterogenity | |||
The prevalence of depression in active duty military | |||||||
Total | 100 (1278837) | 23% (20–26%) | 87.91% | 0.018 | 27.74 | – | – |
Sampling Method | |||||||
Convinces Sampling | 67 (939796) | 21% (18–25%) | 66.90% | 0.030 | 20.25 | 9.33 | 0.001 |
Random Sampling | 33 (339041) | 26% (19–32%) | 54.80% | 0.050 | 13.11 | ||
Type of Forces | |||||||
Air Forces | 5 (4562) | 20% (9–33%) | 83.93% | 0.040 | 5.59 | 8.98 | 0.001 |
Armed Forces | 36 (995073) | 22% (20–23%) | 89.45% | 0.034 | 20.05 | ||
Marine Forces | 6 (775778) | 31% (16–48%) | 90.86% | 0.0001 | 6.22 | ||
Military Forces | 53 (201624) | 22% (16–28%) | 79.89% | 0.005 | 12.41 | ||
Population Healthy Forces | 90 (1152451) | 22% (20–25%) | 99.87% | 0.0001 | 18.28 | 10.03 | 0.001 |
Forces with HIV/AIDS | 3 (113620) | 15% (3–36%) | – | – | 3.16 | ||
Forces with Alcohol Use | 5 (8303) | 29% (13–47%) | 99.96% | 0.0001 | 5.70 | ||
Forces with Substance Use | 2 (4463) | 37%(36–39%) | – | – | 18.04 | ||
Gender | |||||||
Total | 71 (1163273) | 22% (20–25%) | 90.88% | 0.0001 | 20.19 | 10.01 | 0.001 |
Male | 20 (110847) | 23% (12–37%) | 91.83% | 0.0001 | 6.45 | ||
Female | 9 (4717) | 25% (13–40%) | 89.99% | 0.012 | 6.15 | ||
Tools | |||||||
BDI Scale | 9 (38888) | 25% (15–36%) | 65.75% | 0.054 | 5.88 | 5.09 | 0.001 |
CES-D Scale | 7 (15365) | 13% (8–19%) | 50.20% | 0.130 | 4.05 | ||
Interviews | 13 (16980) | 25% (17–35%) | 67.38% | 0.060 | 10.22 | ||
DSM-IV Scale | 36 (202430) | 15% (11–19%) | 60.07% | 0.078 | 12.41 | ||
BSI Scale | 1 (236) | 56% (49–60%) | – | – | – | ||
HAMD Scale | 1 (197) | 47% (40–54%) | – | – | – | ||
HADS Scale | 1 (6943) | 10% (9–11%) | – | – | – | ||
PHQ Scale | 24 (692087) | 15% (13–17%) | 78.62% | 0.059 | 9.32 | ||
SDS Scale | 5 (304767) | 20% (14–26%) | 72.99% | 0.059 | 9.03 | ||
Country | |||||||
Canada | 10 (318747) | 21% (16–26%) | 49.46% | 0.760 | 4.99 | ||
Korea | 2 (430) | 20% (16–24%) | 0.0% | 0.782 | 1.49 | ||
Thailand | 2 (2272) | 39% (37–41%) | 0.0% | 0.800 | 0.98 | 17.74 | 0.001 |
United Kingdom | 6 (2034) | 32% (10–59%) | 54.32% | 0.763 | 4.05 | ||
USA | 66 (929016) | 21% (17–25%) | 78.96% | 0.050 | 13.54 | ||
Greece | 3 (6845) | 20% (1–52%) | 0.0% | 0.980 | 2.43 | ||
The prevalence of depression in veteran military | |||||||
Total | 80 (887982) | 20% (18–22%) | 79.80% | 0.032 | 31.46 | – | – |
Sampling Method | |||||||
Convinces Sampling | 55 (565979) | 19% (16–21%) | 69.78% | 0.049 | 17.25 | 2.12 | 0.150 |
Random Sampling | 25 (322003) | 22% (18–27%) | 58.26% | 0.054 | 10.02 | ||
Type of Forces | |||||||
Air Forces | NR | – | – | – | – | ||
Armed Forces | 68 (583048) | 19% (17–22%) | 76.97% | 0.054 | 16.88 | 1.27 | 0.260 |
Marine Forces | NR | – | – | – | – | ||
Military Forces | 12 (304934) | 24% (16–33%) | 64.66% | 0.034 | 9.83 | ||
Population | |||||||
Healthy Forces | 64 (856091) | 19% (17–22%) | 99.09% | 0.0001 | 18.28 | 28.40 | 0.001 |
Forces with HIV/AIDS | 2 (1257) | 16% (14–18%) | 91.33% | 0.0001 | 22.32 | ||
Forces with Alcohol Use | 4 (1780) | 29% (21–37%) | 98.44% | 0.0001 | 11.92 | ||
Forces with Substance Use | 4 (4397) | 10%(6–14%) | 74.50% | 0.0001 | 8.68 | ||
Forces with HCV | 6 (24457) | 29% (17–43%) | 88.93 | 0.001 | 7.36 | ||
Gender | |||||||
Total | 55 (237654) | 20% (17–23%) | 90.88% | 0.0001 | 22.36 | 0.12 | 0.873 |
Male | 15 (343584) | 21% (13–31%) | 91.91% | 0.0001 | 7.75 | ||
Female | 10 (306744) | 20% (14–26%) | 88.49% | 0.0001 | 11.40 | ||
Tools | |||||||
BDI Scale | 7 (415692) | 14% (9–21%) | 55.15% | 0.060 | 7.97 | ||
CES-D Scale | 11 (318802) | 18% (13–25%) | 40.45% | 0.761 | 10.80 | ||
Interviews | 13 (50675) | 20% (11–31%) | 60.22% | 0.181 | 6.74 | ||
DSM-IV Scale | 11 (64263) | 15% (9–22%) | 78.99% | 0.028 | 7.54 | ||
PHQ Scale | 29 (28445) | 21% (17–25%) | 78.48% | 0.049 | 17.52 | ||
SDS Scale | 2 (1300) | 47% (44–50%) | 52.04% | 0.059 | 9.14 | ||
GDS Scale | 1 (1032) | 37% (34–40%) | – | 20.91 | |||
MHI Scale | 4 (3649) | 35% (15–59%) | −50.74% | 0.601 | 4.91 | ||
QIDS Scale | 1 (1002) | 21% (18–24%) | – | – | 19.13 | ||
HDRS Scale | 1 (3122) | 7% (6–8%) | – | – | 18.28 | 22.16 | 0.001 |
Country | |||||||
Canada | 2 (2365) | 13% (10–15%) | 0.0% | 0.880 | 3.85 | ||
Croatia | 2 (118669) | 4% (6–8%) | 0.0% | 0.893 | 4.91 | 31.46 | 0.001 |
USA | 70 (733009) | 20% (18–22%) | 67.84% | 0.049 | 29.94 |
Publication bias, and meta-regression in studies related to the active military
Prevalence of depression in veterans
Publication bias, and meta-regression in studies related to veterans
Prevalence of suicide in the military
Categories | No. of Studies (Sample Size) | Pooled Prevalence (% 95 CI) | Between studies heterogeneity assessment (%) | Between subgroups heterogeneity assessment (%) | |||
---|---|---|---|---|---|---|---|
I2 | PHeterogenity | Z | Q | PHeterogenity | |||
The prevalence of suicide thought in military | |||||||
Military Statue | |||||||
Active Duty | 31 (424253) | 10% (7–13%) | 67.55% | 0.402 | 12.55 | 2.24 | 0.130 |
Veteran | 18 (335121) | 14% (10–20%) | 69.77% | 0.329 | 9.59 | ||
Sampling Method | |||||||
Convinces Sampling | 40 (151199) | 12% (10–15%) | 57.23% | 0.170 | 20.37 | 15.76 | 0.001 |
Random Sampling | 9 (608175) | 7% (6–9%) | 74.31% | 0.059 | 17.83 | ||
Type of Forces | |||||||
Air Forces | 2 (441) | 19% (15–22%) | 78.99% | 0.041 | 17.36 | 30.05 | 0.001 |
Armed Forces | 23 (434677) | 8% (5–11%) | 88.68% | 0.025 | 9.57 | ||
Marine Forces | 2 (295715) | 1% (1–2%) | 93.86% | 0.0001 | 10.98 | ||
Military Forces | 22 (28982) | 16% (12–21%) | 77.83% | 0.041 | 13.22 | ||
Population Healthy Forces | 42 (757597) | 11% (9–13%) | 99.80% | 0.0001 | 20.07 | 1.74 | 0.420 |
Forces with HIV/AIDS | – | – | – | – | |||
Forces with Alcohol Use | 1 (93) | 9% (4–13%) | – | – | 4.45 | ||
Forces with Substance Use | 6 (1684) | 18%(7–33%) | 97.74% | 0.0001 | 4.91 | ||
Gender | |||||||
Total | 44 (756218) | 11% (9–13%) | 88.72% | 0.0001 | 20.10 | 12.30 | 0.001 |
Male | 2 (1532) | 14% (12–16%) | 90.00% | 0.0001 | 10.94 | ||
Female | 3 (1624) | 20% (14–27%) | 75.22% | 0.017 | 28.78 | ||
Tools | |||||||
BSSI-C Scale | 5 (12775) | 11% (7–16%) | 67.96% | 0.052 | 8.98 | 24.84 | 0.001 |
SCRENNER Scale | 1 (669) | 8% (6–10%) | – | – | 13.54 | ||
SCID DSM-IV Scale | 16 (375640) | 7% (5–10%) | 69.80% | 0.049 | 10.23 | ||
MPSI Scale | 2 (1225) | 39% (36–41%) | 55.21% | 0.077 | 15.52 | ||
PHQ Scale | 15 (324540) | 9% (6–13%) | 53.01% | 0.850 | 9.61 | ||
SITBI Scale | 2 (443) | 36% (32–41%) | 44.34% | 0.501 | 13.35 | ||
SBQ-R Scale | 7 (5845) | 16% (14–18%) | 77.69% | 0.053 | 12.25 | ||
C-SSRS Scale | 1 (38237) | 14% (12–18%) | – | – | 14.98 | ||
Country | |||||||
USA | 42 (707764) | 12% (10–14%) | 79.90% | 0.001 | 19.65 | 21.35 | 0.001 |
Canada | 6 (49560) | 7% (6–10%) | 76.92% | 0.001 | 14.19 | ||
The prevalence of suicide attempted in military | |||||||
Military Statue | |||||||
Active Duty | 19 (98426) | 8% (6–10%) | 50.18% | 0.497 | 12.14 | 10.13 | 0.001 |
Veteran | 23 (340464) | 15% (11–19%) | 69.80% | 0.122 | 12.59 | ||
Sampling Method | |||||||
Convinces Sampling | 35 (133437) | 11% (9–13%) | 77.78% | 0.059 | 16.11 | 0.30 | 0.660 |
Random Sampling | 7 (305453) | 13% (7–20%) | 64.26% | 0.051 | 6.47 | ||
Type of Forces | |||||||
Air Forces | 4 (4851) | 13% (1–35%) | 79.99% | 0.047 | 2.54 | ||
Armed Forces | 23 (121644) | 12% (9–15%) | 76.44% | 0.044 | 14.50 | 1.27 | 0.260 |
Marine Forces | 1 (100) | 54% (44–64%) | – | – | 15.54 | ||
Military Forces | 14 (312295) | 8% (4–12%) | 74.77% | 0.034 | 6.82 | ||
Population | |||||||
Healthy Forces | 35 (435640) | 9% (8–11%) | 99.09% | 0.0001 | 18.52 | 84.99 | 0.001 |
Forces with HIV/AIDS | 1 (442) | 5% (4–8%) | – | – | 19.33 | ||
Forces with Alcohol Use | 1 (1210) | 8% (7–10%) | – | – | 14.59 | ||
Forces with Substance Use | 5 (1598) | 30%(23–36%) | 87.44% | 0.0001 | 8.99 | ||
Forces with HCV | – | – | – | – | – | ||
Gender | |||||||
Total | 37 (429113) | 11% (9–13%) | 92.88% | 0.0001 | 9.04 | 9.56 | 0.001 |
Male | 2 (4533) | 3% (2–4%) | 95.91% | 0.0001 | 2.49 | ||
Female | 3 (5244) | 21% (1–53%) | 98.49% | 0.0001 | 10.75 | ||
Tools | |||||||
BSSI-C Scale | 6 (9800) | 15% (10–22%) | 66.33% | 0.050 | 9.04 | 35.33 | 0.001 |
Checklist | 6 (6882) | 11% (5–20%) | 78.31% | 0.049 | 5.25 | ||
SCID DSM-IV Scale | 12 (373059) | 5% (3–7%) | 61.99% | 0.041 | 11.15 | ||
MPSI Scale | 2 (1225) | 36% (33–38%) | 55.99% | 0.055 | 43.39 | ||
PHQ Scale | 4 (4675) | 9% (5–15%) | 70.05% | 0.039 | 6.54 | ||
MINI-Plus Scale | 2 (2417) | 4% (4–5%) | 60.44% | 0.041 | 19.36 | ||
SBQ-R Scale | 3 (526) | 11% (1–49%) | 69.01% | 0.050 | 1.42 | ||
SITBI Scale | 1 (374) | 8% (5–11%) | – | – | 10.00 | ||
C-SSRS Scale | 2 (38330) | 1% (1–2%) | 62.99% | 0.034 | 32.48 | ||
NR | 3 (692) | 22% (2–53%) | 79.90% | 0.045 | 2.76 | ||
Country | |||||||
Australia | 2 (2279) | 2% (1–4%) | 0.0% | 0.777 | 12.13 | ||
Canada | 2 (37606) | 1% (1–2%) | 0.0% | 0.832 | 25.28 | ||
Korea | 2 (2417) | 4% (3–5%) | 0.0% | 0.489 | 19.36 | 19.75 | 0.001 |
United Kingdom | 3 (10492) | 5% (2–8%) | 0.0% | 0.880 | 6.64 | ||
USA | 33 (386096) | 14% (11–16%) | 60.98% | 0.066 | 16.97 |