Since 2001, the US military has increasingly relied on National Guard and reserve component forces to meet operational demands. Differences in preparation and military engagement experiences between active component and reserve component forces have long suggested that the psychiatric consequences of military engagement differ by component. We conducted a systematic review of prevalence and new onset of psychiatric disorders among reserve component forces and a meta-analysis of prevalence estimates comparing reserve component and active component forces, and we documented stage-sequential drivers of psychiatric burden among reserve component forces. We identified 27 reports from 19 unique samples published between 1985 and 2012: 9 studies reporting on the reserve component alone and 10 reporting on both the reserve component and the active component. The pooled prevalence for alcohol use disorders of 14.5% (95% confidence interval: 12.7, 15.2) among the reserve component was higher than that of 11.7% (95% confidence interval: 10.9, 12.6) among the active component, while there were no component differences for depression or post-traumatic stress disorder. We observed substantial heterogeneity in prevalence estimates reported by the reserve component. Published studies suggest that stage-sequential risk factors throughout the deployment cycle predicted alcohol use disorders, post-traumatic stress disorder and, to a lesser degree, depression. Improved and more standardized documentation of the mental health burden, as well as study of explanatory factors within a life-course framework, is necessary to inform mitigating strategies and to reduce psychiatric burden among reserve component forces.

中文翻译：

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后备役军事人员和退伍军人的心理健康。

自2001年以来，美军越来越依赖国民警卫队和后备分队来满足作战需求。长期以来，现役部队和预备役部队之间在准备和军事交战方面的差异表明，军事交战的精神病后果因各部门而异。我们对后备役部队中精神病的患病率和新发疾病进行了系统的回顾，并比较了后备役部队和现役军人的患病率估计值进行了荟萃分析，并记录了后备役部队中精神病负担的阶段顺序驱动因素。我们从1985年至2012年发布的19个独特样本中确定了27个报告：9项研究仅报告储备金部分，10项报告有关储备金部分和现用部分。储备成分中酒精使用障碍的合并患病率为14.5％（95％置信区间：12.7，15.2），高于活动成分中的11.7％（95％置信区间：10.9，12.6），而没有活性成分抑郁症或创伤后应激障碍的成分差异。我们观察到储备组成部分报告的患病率估计存在很大的异质性。已发表的研究表明，在整个部署周期中，按阶段顺序排列的危险因素可预测酒精使用障碍，创伤后应激障碍以及抑郁症（程度较小）。改善和规范精神健康负担的文件，