Prevalence represents the overall proportion of individuals in a population who have the disorder of interest. It is different from incidence, which represents only the new cases that have developed over a particular time period. Point prevalence is the proportion of individuals who have the disorder at a given point in time. Period prevalence is the proportion of individuals who have the disorder over specific time periods. Lifetime prevalence is the proportion of individuals who have ever had the disorder. Lifetime morbid risk also includes those who had the disorder but were deceased at the time of the survey.

What is the evidence for the prevalence of PTSD in soldiers and veterans?

After military deployment to Iraq or Afghanistan, moderate quality evidence found the overall prevalence of PTSD was 23%. Rates were higher in Iraq-deployed personnel (12.9%) than in Afghanistan-deployed personnel (7.1%). They were higher in combat deployed personnel (12.4%) than in support personnel (4.9%). Rates were higher in army (13.2%) and marine (10.4%) personnel than in navy (7.3%) or air force (2.6%) personnel. They were higher in reserve or National Guard personnel (14.5%) than in active-duty personnel (11.4%).

The overall prevalence of PTSD in US army reserve members was 9.8%, and in US active service members, it was 8.9%. The prevalence of PTSD in peacekeepers between one month before and 6.6 years after deployment was around 5.3%. Prevalence of PTSD in UK service personnel ranged from 2.5% mid-deployment to 4.3% by over 2 years post-deployment.

Prevalence of PTSD was higher in military samples with a traumatic brain injury than in military samples without a traumatic brain injury (36.8% vs. 10.8%). The prevalence of PTSD in ex-military personnel with any physical impairment was between 2% and 59%.

The prevalence of PTSD in older US veterans (>65 years) was around 8.4%, and the prevalence of PTSD in US veterans involved in the justice system was between 4% and 39%.

August 2021

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Exposure to at least one trauma is required for a diagnosis of PTSD. The latest version of the Diagnostic and Statistical Manual of Mental Disorders (DSM-5) determines direct traumas as threatened death, actual or threatened serious injury, or actual or threatened sexual violence. Indirect traumas include witnessing the trauma, or learning that a relative or close friend was exposed to a trauma. Differences in trauma characteristics, along with differences in personal characteristics, may affect the risk of developing PTSD.

What is the evidence regarding war and terrorism and PTSD?

Moderate to high quality evidence finds a large effect of more post-traumatic stress symptoms in World War 2 holocaust survivors than in people with no holocaust background. The effect was largest in people who were children when exposed. There was a small effect of increased PTSD in children exposed to the Israeli-Palestinian conflict.

The prevalence of PTSD in war-affected refugees and citizens is around 31%. Rates were highest in samples exposed to recent conflict, torture, and political terror. They were highest in people from Cambodia, Bosnia, Kosovo, and Africa. The risk factors associated with increased PTSD in military personnel and veterans exposed to combat include; discharging a weapon, witnessing someone being wounded or killed, experiencing severe trauma, and having deployment-related stressors. Also, being in the army rather than other military branches, having direct combat exposure, being a non-officer, having previous adverse life events, being combat specialists, being female, having prior psychological problems, low education, longer and more deployments, being non-White, and having previous prior trauma. There were protective effects of having high unit cohesion and post-deployment support in military personnel and veterans.

There was a medium-sized increase in PTSD in people directly rather than indirectly exposed to the New York World Trade Centre attack. Rates were highest in civilians and in people who were injured during the attack.

August 2021

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Prevalence quantifies the proportion of individuals in a population who have a disorder during a specific time period, while incidence refers to the number of new cases that develop in a population during a specific time period. In disorders of short duration, incidence and prevalence rates may be similar, however with disorders of long duration, such as bipolar disorder, there can be variation between the two. Current, or ‘point’ prevalence is the proportion of individuals who have the disorder at a given point in time, ‘period’ prevalence measures the proportion of individuals who have the disorder during a specified period (e.g. 1 year), a ‘lifetime’ prevalence is the proportion of individuals in the population who have ever had the disorder.

What is the evidence on prevalence of bipolar disorder in veterans?

Moderate quality evidence suggests the current prevalence of bipolar spectrum disorders in elderly veterans in the USA is around 4%.

No reviews were identified that assessed rates in veterans in other regions.

October 2021

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Prevalence quantifies the proportion of individuals in a population who have a disease during a specific time period, while incidence refers to the number of new cases of disease that develop in a population during a specific time period. In disorders of short duration, incidence and prevalence rates may be similar, however with disorders of long duration such as with schizophrenia there can be variation between the two.

Does the prevalence of schizophrenia in veteran populations and conflict settings?

Moderate quality evidence suggests the current prevalence of schizophrenia in elderly veterans in the USA is around 11%. Moderate to low quality evidence suggests the prevalence of schizophrenia in conflict settings in East Timor is 0.34% and in South Darfur, Sudan is 4.1%.

April 2022

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