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Thirty-day prevalence of DSM-IV mental disorders among nondeployed soldiers in the US Army: results from the Army Study to Assess Risk and Resilience in Servicemembers (Army STARRS).
- Source :
-
JAMA psychiatry [JAMA Psychiatry] 2014 May; Vol. 71 (5), pp. 504-13. - Publication Year :
- 2014
-
Abstract
- Importance: Although high rates of current mental disorder are known to exist in the US Army, little is known about the proportions of these disorders that had onsets prior to enlistment.<br />Objective: To estimate the proportions of 30-day DSM-IV mental disorders among nondeployed US Army personnel with first onsets prior to enlistment and the extent which role impairments associated with 30-day disorders differ depending on whether the disorders had pre- vs post-enlistment onsets.<br />Design, Setting, and Participants: A representative sample of 5428 soldiers participating in the Army Study to Assess Risk and Resilience in Servicemembers completed self-administered questionnaires and consented to linkage of questionnaire responses with administrative records.<br />Main Outcomes and Measures: Thirty-day DSM-IV internalizing (major depressive, bipolar, generalized anxiety, panic, and posttraumatic stress) and externalizing (attention-deficit/hyperactivity, intermittent explosive, alcohol/drug) disorders were assessed with validated self-report scales. Age at onset was assessed retrospectively. Role impairment was assessed with a modified Sheehan Disability Scale.<br />Results: A total of 25.1% of respondents met criteria for any 30-day disorder (15.0% internalizing; 18.4% externalizing) and 11.1% for multiple disorders. A total of 76.6% of cases reported pre-enlistment age at onset of at least one 30-day disorder (49.6% internalizing; 81.7% externalizing). Also, 12.8% of respondents reported severe role impairment. Controlling for sociodemographic and Army career correlates, which were broadly consistent with other studies, 30-day disorders with pre-enlistment (χ₈² = 131.8, P < .001) and post-enlistment (χ₇² = 123.8, P < .001) ages at onset both significantly predicted severe role impairment, although pre-enlistment disorders were more consistent powerful predictors (7 of 8 disorders significant; odds ratios, 1.6-11.4) than post-enlistment disorders (5 of 7 disorders significant; odds ratios, 1.5-7.7). Population-attributable risk proportions of severe role impairment were 21.7% for pre-enlistment disorders, 24.3% for post-enlistment disorders, and 43.4% for all disorders.<br />Conclusions and Relevance: Interventions to limit accession or increase resilience of new soldiers with pre-enlistment mental disorders might reduce prevalence and impairments of mental disorders in the US Army.
- Subjects :
- Adult
Age of Onset
Cross-Sectional Studies
Disability Evaluation
Female
Health Surveys
Humans
Internal-External Control
Male
Mental Disorders diagnosis
Risk Factors
Socioeconomic Factors
Surveys and Questionnaires
United States
Young Adult
Afghan Campaign 2001-
Diagnostic and Statistical Manual of Mental Disorders
Iraq War, 2003-2011
Mental Disorders epidemiology
Mental Disorders psychology
Military Personnel psychology
Military Personnel statistics & numerical data
Resilience, Psychological
Risk Assessment
Subjects
Details
- Language :
- English
- ISSN :
- 2168-6238
- Volume :
- 71
- Issue :
- 5
- Database :
- MEDLINE
- Journal :
- JAMA psychiatry
- Publication Type :
- Academic Journal
- Accession number :
- 24590120
- Full Text :
- https://doi.org/10.1001/jamapsychiatry.2014.28