摘要 :
The 12-month prevalence of common mental illnesses in the United States is estimated to be 26 percent, accounting for a large and increasing fraction of all disability in the U.S. general population. The U.S. military is frequentl...
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The 12-month prevalence of common mental illnesses in the United States is estimated to be 26 percent, accounting for a large and increasing fraction of all disability in the U.S. general population. The U.S. military is frequently called upon as the first line of response or defense in conflicts and disasters, often resulting in service members' separation from family or home life for extended periods of time. Reports have suggested that personnel involved in combat operations or peacekeeping missions following combat may have increased symptoms of psychological distress, with one report recently suggesting significant risk of mental health problems after combat duty in Iraq and Afghanistan. The mental health of military service members affects organizational productivity and effectiveness and is of great importance to the U.S. military for retention, readiness, and mission capability. In this report, the authors describe the baseline prevalence of mental disorders in a large U.S. military cohort, the Millennium Cohort, that will be longitudinally followed until 2022. Using crude and weighted prevalence and multivariable logistic regression, the mental health morbidity of the Millennium Cohort is reported for a variety of demographic characteristics. The findings suggest a mentally healthier population than other comparison populations. However, the higher prevalence of alcohol abuse and the disproportionately higher burden of mental disorders among some subgroups -- members who are female, younger, less educated, single, White (non-Hispanic), short-term service, enlisted, and Army - - should prompt further clinical investigation and intervention. Further coordination between primary care providers, mental health specialists, and researchers is necessary to identify and prioritize critical areas for research and improvement of clinical services to protect the mental health of the U.S. military.
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摘要 :
The Millennium Cohort Study began in 2001 using mail and Internet questionnaires to gather occupational and environmental exposure, behavioral risk factor, and health outcome data from a large, population-based US military cohort....
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The Millennium Cohort Study began in 2001 using mail and Internet questionnaires to gather occupational and environmental exposure, behavioral risk factor, and health outcome data from a large, population-based US military cohort. Standardized instruments, including the Patient Health Questionnaire, the Medical Outcomes Study Short Form-36 for Veterans, and the Posttraumatic Stress Disorder (PTSD) Checklist-Civilian Version, have been validated in various populations. The purpose of this study was to investigate internal consistency of standardized instruments and concordance of responses in a test- retest setting. Cronbach alpha coefficients were used to investigate the internal consistency of standardized instruments among 76,742 participants. Kappa statistics were calculated to measure stability of aggregated responses in a subgroup of 470 participants who voluntarily submitted an additional survey within 6 months of their original submission. High internal consistency was found for 14 of 16 health components, with lower internal consistency found among two alcohol components. Substantial test-retest stability was observed for stationary variables, while moderate stability was found for more dynamic variables that measured conditions with low prevalence. These results substantiate internal consistency and stability of several standard health instruments applied to this large cohort. Such reliability analyses are vital to the integrity of long-term outcome studies.
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