Piccirillo Amanda L, Packnett Elizabeth R, Boivin Michael R, Cowan David N
Department of Epidemiology, Preventive Medicine Branch, Walter Reed Army Institute of Research, 503 Robert Grant Avenue, Silver Spring, MD 20910, USA; ManTech International Corporation, Health and Life Sciences, 13755 Sunrise Valley Drive, Herndon, VA 20171, USA.
Department of Epidemiology, Preventive Medicine Branch, Walter Reed Army Institute of Research, 503 Robert Grant Avenue, Silver Spring, MD 20910, USA; ManTech International Corporation, Health and Life Sciences, 13755 Sunrise Valley Drive, Herndon, VA 20171, USA.
J Psychiatr Res. 2015 Dec;71:56-62. doi: 10.1016/j.jpsychires.2015.09.010. Epub 2015 Sep 15.
Psychiatric disorders are a common reason for disability discharge from the U.S. military. Research on psychiatric disorders in military personnel evaluated for disability discharge has historically focused on posttraumatic stress disorder (PTSD), yet 40% of service members evaluated for a psychiatric-related disability do not have PTSD. This study's objective was to describe characteristics and correlates of disability in Army and Marine Corps personnel diagnosed with psychiatric disorders other than PTSD. In this cross-sectional study, the chi-square and Wilcoxon-Mann-Whitney tests compared the distribution of demographic, disability and deployment characteristics between those evaluated for non-PTSD psychiatric disability (N = 9125) versus those evaluated for any other non-psychiatric condition (N = 78,072). Multivariate logistic regression examined associations between disability retirement and demographic and disability characteristics. Results show a significantly higher prevalence of disability retirement, deployment, and comorbidity among Army and Marine Corps personnel evaluated for disability discharge related to a non-PTSD psychiatric disorder. Mood disorders, anxiety disorders and dementia were the most commonly evaluated psychiatric disorders. Characteristics associated with increased odds of non-PTSD psychiatric-related disability retirement includes being in the Marine Corps (OR = 1.24), being black (OR = 1.29) or other race (OR = 1.33), having a combat-related condition (OR = 2.50), and older age. Service members evaluated for a non-PTSD psychiatric disability have similar rates of disability retirement as those evaluated for PTSD, suggesting non-PTSD psychiatric disorders cause a severe and highly compensated disability. Additional research is needed describing the epidemiology of specific non-PTSD psychiatric disorders, such as depression, in service members evaluated for disability discharge.
精神疾病是美国军人因残疾退伍的常见原因。历史上，针对因残疾退伍接受评估的军人精神疾病的研究主要集中在创伤后应激障碍（PTSD）上，然而，在因精神相关残疾接受评估的军人中，40%并没有患创伤后应激障碍。本研究的目的是描述被诊断患有除创伤后应激障碍之外的精神疾病的陆军和海军陆战队人员的残疾特征及相关因素。在这项横断面研究中，卡方检验和威尔科克森-曼-惠特尼检验比较了因非创伤后应激障碍精神残疾接受评估的人员（N = 9125）与因任何其他非精神疾病接受评估的人员（N = 78072）在人口统计学、残疾和部署特征方面的分布情况。多变量逻辑回归分析了残疾退休与人口统计学和残疾特征之间的关联。结果显示，在因与非创伤后应激障碍精神疾病相关的残疾退伍接受评估的陆军和海军陆战队人员中，残疾退休、部署和共病的患病率显著更高。情绪障碍、焦虑症和痴呆是最常被评估的精神疾病。与非创伤后应激障碍精神相关残疾退休几率增加相关的特征包括在海军陆战队服役（比值比 = 1.24）、黑人（比值比 = 1.29）或其他种族（比值比 = 1.33）、患有与战斗相关的疾病（比值比 = 2.50）以及年龄较大。因非创伤后应激障碍精神残疾接受评估的军人的残疾退休率与因创伤后应激障碍接受评估的军人相似,这表明非创伤后应激障碍精神疾病会导致严重且获得高额补偿的残疾。需要进行更多研究来描述在因残疾退伍接受评估的军人中，诸如抑郁症等特定非创伤后应激障碍精神疾病的流行病学情况。
