PREVALENCE OF POSTTRAUMATIC STRESS DISORDER AMONG CURRENT AND FORMER MEMBERS OF THE CANADIAN ARMED FORCES

Abstract

Objective: This study aims to synthesize the literature regarding the prevalence of posttraumatic stress disorder (PTSD) among current and former members of the Canadian Armed Forces (CAF). Methods: We searched EMBASE, MEDLINE, PsycINFO, and CINAHL from inception until June 2024 for studies reporting on the prevalence of PTSD among Canadian military personnel and veterans. We performed a Freeman-Tukey double arcsine transformation to stabilize the variance and then pooled the prevalence of PTSD across studies using a random-effects model. We assessed the credibility of subgroup effects using the Instrument to Assess the Credibility of Effect Modification Analyses (ICEMAN) tool. We used the Grading of Recommendations, Assessment, Development, and Evaluation (GRADE) approach to assess the certainty of evidence. Results: We included 34 observational studies. The pooled prevalence of PTSD was 35.5%, however we found evidence of credible subgroup effects based on representativeness of the study population, and proportion of veterans included. High certainty evidence from 10 representative studies (n=58,060) suggests the prevalence of PTSD among active CAF members is 5.8% (95% CI: 4.1 to 7.8%). Moderate certainty evidence from 7 representative studies (n=13,194) suggests the prevalence of PTSD is probably 15.4% (95% CI: 7.5–25.4%) among CAF veterans. Conclusions: We found high certainty evidence that 6 in every 100 CAF members live with PTSD, and moderate certainty evidence that 15 in every 100 Canadian veterans live with PTSD. These findings highlight the need for PTSD screening and access to care for current and former CAF members, and further research to identify evidence-based care.