Larson Gerald E, Booth-Kewley Stephanie, Highfill-McRoy Robyn M, Young Sylvia Y N
Naval Health Research Center, 140 Sylvester Road, San Diego, CA 92106-3521, USA.
Mil Med. 2009 Jul;174(7):737-44. doi: 10.7205/milmed-d-02-0308.
The objective of this longitudinal study was to identify risk factors for combat-related psychiatric disorders. The sample consisted of 6442 enlisted U.S. Marines who completed a questionnaire during basic training, deployed to a combat zone with no prior psychiatric diagnoses, and completed a postdeployment assessment form. Cox proportional hazards regression was used to determine associations between predeployment and postdeployment self-reports and subsequent mental health outcomes. During the observation period, 6.8% of the sample were diagnosed with a psychiatric disorder. The strongest predictors of postdeployment psychiatric disorders were, in order of importance, low paygrade, hospitalization during deployment, low education, preservice smoking, and post-traumatic stress disorder symptoms at deployment's end. The impact of war zone variables was smaller than expected. It was recommended that the combat experience section of the military's postdeployment assessment form be expanded to enhance the military's ability to identify and refer personnel who may be at risk for psychiatric disorders.
这项纵向研究的目的是确定与战斗相关的精神障碍的风险因素。样本包括6442名美国海军陆战队士兵，他们在基础训练期间完成了一份问卷，在没有先前精神疾病诊断的情况下被部署到战斗区，并完成了一份部署后评估表。采用Cox比例风险回归来确定部署前和部署后自我报告与随后心理健康结果之间的关联。在观察期内，6.8%的样本被诊断患有精神障碍。部署后精神障碍的最强预测因素按重要性排序为低军阶、部署期间住院、低教育水平、服役前吸烟以及部署结束时的创伤后应激障碍症状。战区变量的影响小于预期。建议扩大军方部署后评估表中的战斗经历部分，以提高军方识别和转介可能有精神障碍风险人员的能力。
