Prevalence and determinants of antidepressant use among canadian forces members experiencing major depressive episodes

Background Major depression affects a significant proportion of individuals including those serving in the military; but, there is less information on the pharmacological treatment they receive. Objectives We assessed the prevalence and determinants of past year antidepressant use among regular and reservist members of the Canadian Forces who have experienced major depressive episodes in the past 12 months. Methods The 2002 Canadian Community Health Survey Cycle 1.2 Canadian Forces Supplement (CCHS1.2-CFS) surveyed 8441 active members of the Canadian Forces. Individuals who reported experiencing major depressive episodes (MDE) in the past 12 months, according to the definition of the Diagnostic and Statistical Manual of Mental Disorders, 4th Edition (DSM-IV), were examined with data from the CCHS1.2-CFS. Regression models assessed sociodemographic determinants and service factors of antidepressant use employing appropriate weights and bootstrapping variance estimation methods. Results Overall, 7.4% of members of the Canadian Forces experienced MDE in the past 12 months, and of those only 32.1% reported to have taken an antidepressant. Significant predictors of antidepressant use were marital status i.e. married/common law (OR=3.6, 95%CI 2.0-6.4), widowed/separated/divorced (OR=4.0, 95%CI 2.0-8.4), and being in both combat and peacekeeping missions (OR=2.2, 95%CI 1.3-3.8). Conclusion Findings highlight the characteristics that predispose individuals in the Canadian Forces with MDE to use antidepressant, and serves as a baseline to determine the effectiveness of ongoing programs for diagnosis, treatment and prevention of major depression. Continued research involving the Canadian Forces will foster better understanding of mental health outcomes and effective interventions to improve care.