ABSTARCT

Background

Mental disorders and alcohol misuse are often comorbid, and this comorbidity is more common in those who develop mental disorders following exposure to traumatic events.

Aims

To investigate the relationship between combat exposure and operational role (support versus combat) with mental disorders and associated comorbidity in a UK military cohort.

Methods

4896 participants from a UK military cohort reported their operational role and frequency of exposure to combat events during deployment. Outcome measures included self-reported post-traumatic stress disorder, common mental disorder and alcohol misuse.

Results

Personnel reporting higher levels of combat exposure were more likely to meet criteria for two or more co-occurring mental disorders (odds ratio [OR] 3.90, 95% confidence interval [CI] 2.73–5.58). While having a combat role increased the risk of developing co-occurring disorders compared to having a support role (OR 1.67, 95% CI 1.26–2.23), this effect diminished following adjustment for variables including combat exposure (OR 0.89, 95% CI 0.62–1.27).

Conclusions

Combat exposure may play a greater role in the development of comorbid mental disorders than operational role, i.e. job title. Clinicians treating military personnel should be alert to the increased risk of comorbid mental disorders and alcohol misuse among those with a history of combat exposure.

中文翻译：

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打击英国武装部队人员的暴露和同时发生的心理健康问题

摘要

背景

精神障碍和酒精滥用通常是共病的，这种共病在那些因遭受创伤事件而发展为精神障碍的人中更为常见。

目标

在英国军事队列中调查战斗暴露和作战角色（支持与战斗）与精神障碍和相关合并症之间的关系。

方法

来自英国军事队列的 4896 名参与者报告了他们在部署期间的作战角色和接触战斗事件的频率。结果测量包括自我报告的创伤后应激障碍、常见的精神障碍和酒精滥用。

结果

报告战斗暴露水平较高的人员更有可能满足两种或多种同时发生的精神障碍的标准（优势比 [OR] 3.90，95% 置信区间 [CI] 2.73-5.58）。虽然与担任支持角色相比，担任战斗角色会增加同时发生疾病的风险（OR 1.67，95% CI 1.26-2.23），但在调整包括战斗暴露在内的变量后，这种影响会减弱（OR 0.89，95% CI 0.62） –1.27)。

结论

与操作角色（即职务）相比，战斗暴露在共病精神障碍的发展中可能发挥更大的作用。治疗军人的临床医生应该警惕那些有战斗暴露史的人患精神障碍和酗酒的风险增加。