Rusu Corneliu, Zamorski Mark A, Boulos David, Garber Bryan G
Directorate of Mental Health, Canadian Forces Health Services Group, Ottawa, ON
Directorate of Mental Health, Canadian Forces Health Services Group, Ottawa, ON Department of Family Medicine, Faculty of Medicine, University of Ottawa, Ottawa, ON.
Can J Psychiatry. 2016 Apr;61(1 Suppl):46S-55S. doi: 10.1177/0706743716628856.
Military personnel in Canada and elsewhere have been found to have higher rates of certain mental disorders relative to their corresponding general populations. However, published Canadian data have only adjusted for age and sex differences between the populations. Additional differences in the sociodemographic composition, labour force characteristics, and childhood trauma exposure in the populations could be driving these prevalence differences. Our objective is to compare the prevalence of past-year mental disorders and suicidal behaviours in the Canadian Armed Forces Regular Force with the rates in a representative, matched sample of Canadians in the general population (CGP).
Data sources were the 2013 Canadian Forces Mental Health Survey and the 2012 Canadian Community Health Survey-Mental Health. CGP sample was restricted to match the age range, employment status, and history of chronic conditions of Regular Force personnel. An iterative proportional fitting method was used to approximate the marginal distribution of sociodemographic and childhood trauma variables in both samples.
Relative to the matched CGP, Regular Force personnel had significantly higher rates of past-year major depressive episode, generalized anxiety disorder, and suicide ideation. However, lower rates of alcohol use disorder were seen in Regular Force personnel relative to the matched CGP sample.
Factors other than differences in sociodemographic composition and history of childhood trauma account for the excess burden of mental disorders and suicidal behaviours in the Canadian Armed Forces. Explanations to explore in future research include occupational trauma, selection effects, and differences in the context of administration of the 2 surveys.
与相应的普通人群相比，加拿大及其他地区的军事人员某些精神障碍的发病率更高。然而，已发表的加拿大数据仅对人群间的年龄和性别差异进行了调整。人群在社会人口构成、劳动力特征和童年创伤暴露方面的其他差异可能导致了这些患病率差异。我们的目的是比较加拿大武装部队正规部队中过去一年精神障碍和自杀行为的患病率与普通人群（CGP）中具有代表性的匹配样本的患病率。
数据来源为2013年加拿大军队心理健康调查和2012年加拿大社区健康调查 - 心理健康。CGP样本被限制为与正规部队人员的年龄范围、就业状况和慢性病病史相匹配。采用迭代比例拟合方法来近似两个样本中社会人口和童年创伤变量的边际分布。
相对于匹配的CGP，正规部队人员过去一年中重度抑郁发作、广泛性焦虑障碍和自杀意念的发生率显著更高。然而，相对于匹配的CGP样本，正规部队人员酒精使用障碍的发生率较低。
除了社会人口构成和童年创伤史的差异外，其他因素导致了加拿大武装部队精神障碍和自杀行为的额外负担。未来研究中有待探索的解释包括职业创伤、选择效应以及两项调查实施背景的差异。
