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Psychiatric Conditions and Symptoms After Toxic Environmental Exposures During Military Service

An Evidence Map

Bibliographic Data

ID9104276
AuthorsAnna T Magnante (0000-0002-6489-8732, W.G. (Bill) Hefner Veterans Affairs Healthcare System, Salisbury, NC, corresponding author), Shannon M Nugent (0000-0003-3173-6590, VA Portland Health Care System, Center to Improve Veteran Involvement in Care, Portland, OR), Kyle J Bourassa (0000-0001-9372-2309, VA Mid-Atlantic Mental Illness Research, Education, and Clinical Center, Durham, NC, corresponding author), Nina Leflore-Lloyd (Durham Veterans Affairs Health Care System, Durham, NC), Samantha Mecke (0000-0001-8340-9458, Durham VA Health Care System), Samantha J Meckes (VA Mid-Atlantic Mental Illness Research, Education, and Clinical Center, Durham, NC), Adelaide M Gordon (0000-0001-6453-4579, Durham Center of Innovation to Accelerate Discovery and Practice Transformation, Durham VA Health Care System, Durham, NC), Stephen H Boyle (0009-0008-4413-0815, Durham VA Health Care System), Dazhe Chen (0000-0001-9951-5458, National Institute of Environmental Health Sciences, corresponding author), Amir Alishahi Tabriz (0000-0002-6273-9105, Moffitt Cancer Center), Stephanie Y Wells (0000-0002-5725-7275, VA Mid-Atlantic Mental Illness Research, Education, and Clinical Center, Durham, NC), Morgan Jacobs (Durham Center of Innovation to Accelerate Discovery and Practice Transformation, Durham VA Health Care System, Durham, NC), Julee Snyder (Durham VA Health Care System), Liziqiu Yang (University of Illinois Urbana-Champaign, Urbana, IL), Sarah Cantrell (0000-0003-2694-7836, Duke University Medical Center Library and Archives, Duke University School of Medicine, Durham, NC), Karen M Goldstein (0000-0003-4419-5869, Durham Veterans Affairs Health Care System, Durham, NC), Jennifer M Gierisch (0000-0002-5057-4964, Durham Center of Innovation to Accelerate Discovery and Practice Transformation, Durham VA Health Care System, Durham, NC)
Year2026
Volume64
Issue2S
PagesS137-S148
Publication date2026-01-01
Open AccessNo
TypeARTICLE
VenueMedical Care (JOURNAL)
Journal identifiersISSN: 0025-7079 • E-ISSN: 1537-1948
PublisherOvid Technologies (Wolters Kluwer Health) (PUBLISHER)
DOI10.1097/mlr.0000000000002149
PMID41385259
OpenAlexW4417280197
LanguageEN
Citations received1
References cited49

BACKGROUND: US service members are often exposed to a range of service-related hazards. To date, there has been limited synthesis of the existing research conducted on military environmental exposures and subsequent psychiatric conditions and symptoms. OBJECTIVE: To systematically review and characterize the main features of studies examining associations between military exposures and mental health outcomes. METHODS: We used evidence mapping methodology to systematically search MEDLINE, Embase, PsycINFO, and PTSDpubs for studies of toxic exposure during military service and psychiatric outcomes, which included psychiatric diagnoses, psychiatric symptoms, and neurocognitive functioning. RESULTS: We identified 49 studies; most were comprised of predominantly White, male veteran samples. Chemical exposures, including chemical munitions from the Gulf War era and Agent Orange from the Vietnam War era, were the most frequently examined military toxic exposures. Symptoms of depression, PTSD, and anxiety were the most commonly examined psychiatric outcomes. Only 9 studies assessed neurocognitive functioning. We found extensive variation in how exposures and outcomes were defined and measured. Most exposure and symptom data were based on self-reports. Overall, available evidence suggests that veterans reporting environmental toxic exposures may report relatively high levels of mental health needs. CONCLUSIONS: We found broad evidence that toxic exposure was associated with poorer mental health outcomes, though the ability to draw stronger conclusions is limited by the quality of the current literature. Future research should focus on longitudinal studies of toxic exposure and mental health that include more broadly representative military populations, including diverse samples and more recent service cohorts

Health services · Mental health · Mental health service · Military personnel · Military service · Service (business) · Service member · Fibromyalgia and Chronic Fatigue Syndrome Research · Occupational Health and Performance · Posttraumatic Stress Disorder Research

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Citations per year1
Citation span2026 - 2026 (1)
Highly citedNo

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Open DOIOpen Access
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