Grief and physical health outcomes in U.S. soldiers returning from combat

J Affect Disord. 2012 Feb;136(3):469-75. doi: 10.1016/j.jad.2011.10.048. Epub 2011 Dec 9.


Background: Few studies have measured the burden of physical health problems after Iraq/Afghanistan deployment, except in association with post-traumatic stress disorder (PTSD) or mild traumatic brain injury (mTBI). Grief, a correlate of health problems in the general population, has not been systematically examined. We aimed to identify the prevalence of post-deployment physical health problems and their association with difficulty coping with grief.

Methods: Infantry soldiers (n=1522) completed anonymous surveys using validated instruments six months following deployment in November-December 2008. Multiple logistic regression was used to assess the association of difficulty coping with grief and physical health.

Results: The most frequent physical health symptoms reported were: sleep problems (32.8%), musculoskeletal pain (32.7%), fatigue (32.3%), and back pain (28.1%). Difficulty coping with grief over the death of someone close affected 21.3%. There was a dose-response relationship between level of difficulty coping with grief and principal physical health outcomes (ps<.002). Controlling for demographics, combat experiences, injuries, PTSD, depression, and other factors, grief significantly and uniquely contributed to a high somatic symptom score (adjusted odds ratio (AOR)=3.6), poor general health (AOR=2.0), missed work (AOR=1.7), medical utilization (AOR=1.5), difficulty carrying a heavy load (AOR=1.7), and difficulty performing physical training (AOR=1.6; all 95% confidence intervals>1).

Limitations: Data are cross-sectional and grief was measured with one item.

Conclusions: Over 20% of soldiers reported difficulty coping with grief. This difficulty was significantly associated with physical health outcomes and occupational impairment. Clinicians should be aware of the unique role grief plays in post-deployment physical health when treating patients.

Publication types

  • Research Support, U.S. Gov't, Non-P.H.S.

MeSH terms

  • Adaptation, Psychological
  • Adolescent
  • Adult
  • Afghan Campaign 2001-
  • Cross-Sectional Studies
  • Disease / psychology*
  • Female
  • Grief*
  • Health Status
  • Humans
  • Iraq War, 2003-2011
  • Logistic Models
  • Male
  • Military Personnel / psychology*
  • Military Personnel / statistics & numerical data
  • Prevalence
  • Young Adult