Department of Psychiatry, Uniformed Services University of the Health Sciences, Bethesda, Maryland 20814, USA.
Psychiatr Serv. 2013 Apr 1;64(4):347-53. doi: 10.1176/appi.ps.000602012.
U.S. Army personnel experience significant burden from mental disorders, particularly during times of war and with multiple deployments. This study identified the rates and predictors of mental health service use by Army soldiers and examined the association of daily functioning with the various types of mental health service use.
This study used the U.S. Department of Defense Survey of Health Related Behaviors Among Active Duty Military Personnel, which sampled 10,400 Army soldiers, representing 508,088 soldiers. Mental health service utilization over a 12-month period included receiving counseling or therapy from a general medical doctor, receiving counseling or therapy from a mental health professional, and being prescribed medications for depression, anxiety, or sleep. Current functioning was assessed with the Health-Related Quality of Life-4 instrument.
Of the active U.S. Army, 21% had used mental health services in the previous 12 months, and 48% of them had used two or more services. About 7% of soldiers saw a mental health specialist and were prescribed medication. Women (incidence rate ratio [IRR]=1.39, 95% confidence interval [CI]=1.19-1.63) and enlisted soldiers (IRR=1.93, CI=1.49-2.50) were more likely than others to use a greater number of services. Soldiers with higher versus lower levels of impaired functioning were 7.82 times more likely (CI=6.03-10.14) to use mental health services, 4.40 times more likely (CI=3.83-5.05) to use more services, and 3.18 times more likely (CI=1.85-5.49) to see a mental health specialist and to be prescribed medication.
A substantial proportion of the Army accesses mental health services. Soldiers using the highest levels of care had the greatest impairment.
美国陆军人员承受着严重的精神障碍负担，尤其是在战争时期和多次部署期间。本研究确定了陆军士兵使用心理健康服务的比率和预测因素，并研究了日常功能与各种类型的心理健康服务使用之间的关联。
本研究使用了美国国防部对现役军事人员健康相关行为的调查，该调查对 10400 名陆军士兵进行了抽样调查，代表了 508088 名士兵。在过去 12 个月中，心理健康服务的使用包括向普通内科医生寻求咨询或治疗、向心理健康专业人员寻求咨询或治疗以及因抑郁、焦虑或睡眠问题而开处药物。当前功能使用健康相关生活质量-4 工具进行评估。
在现役美国陆军中，21%的人在过去 12 个月中使用过心理健康服务，其中 48%的人使用了两种或更多服务。约 7%的士兵会去看心理健康专家并开处方药。与其他人相比，女性（发病率比 [IRR]=1.39，95%置信区间 [CI]=1.19-1.63）和 enlisted 士兵（IRR=1.93，CI=1.49-2.50）更有可能使用更多的服务。与功能障碍程度较低的士兵相比，功能障碍程度较高的士兵使用心理健康服务的可能性高出 7.82 倍（CI=6.03-10.14），使用更多服务的可能性高出 4.40 倍（CI=3.83-5.05），看心理健康专家和开处方药的可能性高出 3.18 倍（CI=1.85-5.49）。
相当一部分陆军士兵会使用心理健康服务。使用最高水平护理的士兵功能障碍程度最高。
