Boulos David, Zamorski Mark A
Canadian Forces Health Services Group Headquarters, Ottawa, Ontario
Canadian Forces Health Services Group Headquarters, Ottawa, Ontario Department of Family Medicine, University of Ottawa, Ottawa, Ontario.
Can J Psychiatry. 2016 Apr;61(1 Suppl):64S-76S. doi: 10.1177/0706743716628857.
The purpose of this study was to estimate the contribution of the mission in Afghanistan to the burden of mental health problems in the Canadian Armed Forces (CAF).
Data were obtained from the 2013 Canadian Forces Mental Health Survey, which assessed mental disorders using the World Health Organization's Composite International Diagnostic Interview. The sample consisted of 6696 Regular Force (RegF) personnel, 3384 of whom had deployed in support of the mission. We estimated the association of past-year mental health problems with Afghanistan deployment status, adjusting for covariates using logistic regression; population attributable fractions (PAFs) were also calculated.
Indication of a past-year mental disorder was identified in 18.4% (95% confidence interval [CI], 17.0% to 19.7%) of Afghanistan deployers compared with 14.6% (95% CI, 13.3% to 15.8%) in others. Afghanistan-related deployments contributed to the burden of a past-year disorder (PAF = 8.7%; 95% CI, 3.0% to 14.2%), with the highest PAFs being seen for panic disorder (34.7%) and posttraumatic stress disorder (32.1%). The PAFs for individual alcohol use disorders and suicide ideation were not different from zero. Child abuse, however, had a much greater PAF for any past-year disorder (28.7%; 95% CI, 23.4% to 33.7%) than did the Afghanistan mission.
The mission in Afghanistan contributed significantly to the burden of mental disorders in the CAF RegF in 2013. However, the much stronger contribution of child abuse highlights the need for strong military mental health systems, even in peacetime, and the need to target the full range of determinants of mental health in prevention and control efforts.
本研究旨在评估加拿大武装部队（CAF）在阿富汗执行任务对心理健康问题负担的影响。
数据来自2013年加拿大军队心理健康调查，该调查使用世界卫生组织的综合国际诊断访谈评估精神障碍。样本包括6696名正规部队（RegF）人员，其中3384人曾部署以支持该任务。我们使用逻辑回归估计过去一年心理健康问题与阿富汗部署状态之间的关联，并对协变量进行调整；还计算了人群归因分数（PAF）。
在曾部署到阿富汗的人员中，18.4%（95%置信区间[CI]，17.0%至19.7%）被认定在过去一年有精神障碍迹象，而其他人中这一比例为14.6%（95%CI，13.3%至15.8%）。与阿富汗相关的部署导致了过去一年精神障碍的负担（PAF = 8.7%；95%CI，3.0%至14.2%），其中惊恐障碍（34.7%）和创伤后应激障碍（32.1%）的PAF最高。个体酒精使用障碍和自杀意念的PAF与零无差异。然而，与阿富汗任务相比，儿童期虐待对任何过去一年精神障碍的PAF要高得多（28.7%；95%CI，23.4%至33.7%）。
2013年在阿富汗的任务对CAF RegF中的精神障碍负担有显著影响。然而，儿童期虐待的影响更为强烈，这凸显了即使在和平时期也需要强大的军事心理健康系统，以及在预防和控制工作中针对心理健康的所有决定因素的必要性。
