Williams Emily C, Frasco Melissa A, Jacobson Isabel G, Maynard Charles, Littman Alyson J, Seelig Amber D, Crum-Cianflone Nancy F, Nagel Anna, Boyko Edward J
Denver-Seattle Center of Innovation for Veteran-Centered and Value-Driven Care, Health Services Research Development, Department of Veterans Affairs Puget Sound Health Care System, 1100 Olive Way, Suite 1400, Seattle, WA 98101, USA; Department of Health Services, University of Washington School of Public Health, 1959 NE Pacific St., Magnuson Health Sciences Center, Room H-664, Box 357660, Seattle, WA 98195-7660, USA.
Deployment Health Research Department, Naval Health Research Center, 140 Sylvester Rd, San Diego, CA 92106-3521, USA.
Drug Alcohol Depend. 2015 Mar 1;148:93-101. doi: 10.1016/j.drugalcdep.2014.12.031. Epub 2015 Jan 3.
Military service members may be prone to relapse to problem drinking after remission, given a culture of alcohol use as a coping mechanism for stressful or traumatic events associated with military duties or exposures. However, the prevalence and correlates of relapse are unknown. We sought to identify socio-demographic, military, behavioral, and health characteristics associated with relapse among current and former military members with remittent problem drinking.
Participants in the longitudinal Millennium Cohort Study who reported problem drinking at baseline (2001-2003) and were remittent at first follow-up (2004-2006) were included (n=6909). Logistic regression models identified demographic, military service, behavioral, and health characteristics that predicted relapse (report of ≥1 past-year alcohol-related problem on the validated Patient Health Questionnaire) at the second follow-up (2007-2008).
Sixteen percent of those with remittent problem drinking relapsed. Reserve/National Guard members compared with active-duty members (odds ratio [OR]=1.71, 95% confidence interval [CI]: 1.45-2.01), members separated from the military during follow-up (OR=1.46, 95% CI: 1.16-1.83), and deployers who reported combat exposure (OR=1.32, 95% CI: 1.07-1.62, relative to non-deployers) were significantly more likely to relapse. Those with multiple deployments were significantly less likely to relapse (OR=0.73, 95% CI: 0.58-0.92). Behavioral factors and mental health conditions also predicted relapse.
Relapse was common and associated with military and non-military factors. Targeted intervention to prevent relapse may be indicated for military personnel in particular subgroups, such as Reservists, veterans, and those who deploy with combat exposure.
鉴于饮酒文化被用作应对与军事任务或接触相关的压力或创伤事件的一种应对机制，军人在戒酒缓解后可能容易复发问题饮酒行为。然而，复发的患病率及其相关因素尚不清楚。我们试图确定在有间歇性问题饮酒的现役和退役军人中，与复发相关的社会人口统计学、军事、行为和健康特征。
纳入纵向千禧队列研究的参与者，这些参与者在基线时（2001 - 2003年）报告有问题饮酒且在首次随访时（2004 - 2006年）已缓解（n = 6909）。逻辑回归模型确定了在第二次随访时（2007 - 2008年）预测复发（在经过验证的患者健康问卷上报告过去一年中≥1次与酒精相关问题）的人口统计学、军事服役、行为和健康特征。
有间歇性问题饮酒的人中有16%复发。预备役/国民警卫队成员与现役成员相比（优势比[OR]=1.71，95%置信区间[CI]：1.45 - 2.01），在随访期间脱离军队的成员（OR = 1.46，95% CI：1.16 - 1.83），以及报告有战斗经历的部署人员（相对于未部署人员，OR = 1.32，95% CI：1.07 - 1.62）复发的可能性显著更高。多次部署的人员复发的可能性显著更低（OR = 0.73，95% CI：0.58 - 0.92）。行为因素和心理健康状况也可预测复发。
复发很常见，且与军事和非军事因素相关。对于特定亚组的军事人员，如预备役军人、退伍军人以及有战斗经历的部署人员，可能需要进行有针对性的干预以预防复发。
