Weeks Murray, Zamorski Mark A, Rusu Corneliu, Colman Ian
Dr. Weeks, Dr. Zamorski, and Dr. Rusu are with the Canadian Forces Health Services Group, Department of National Defence, Ottawa. Dr. Colman is with the Department of Epidemiology and Community Medicine, University of Ottawa, Ottawa. Send correspondence to Dr. Colman (e-mail:
Psychiatr Serv. 2017 Jul 1;68(7):710-716. doi: 10.1176/appi.ps.201600398. Epub 2017 Mar 1.
This study sought to compare the prevalence and impacts of mental illness-related stigma among Canadian Armed Forces personnel and Canadian civilians.
Data were from two highly comparable, population-based, cross-sectional surveys of Canadian military personnel and Canadian civilians: the 2013 Canadian Forces Mental Health Survey (N=6,696) and the 2012 Canadian Community Health Survey-Mental Health (N=25,113), respectively. Perceived stigma was assessed among those who reported care seeking for a mental health problem in the past 12 months. Follow-up questions assessed the impact of stigma in various domains. Modified Poisson regression and linear regression were used to examine population differences (military versus civilian) in terms of care seeking, stigma, and stigma impact, with adjustments for sociodemographic characteristics and the need for care.
Military personnel were significantly more likely than civilians to have perceived stigma (adjusted prevalence ratio [PR]=1.70, 95% confidence interval [CI]=1.11-2.60). Stigma had a greater impact on military personnel, particularly in terms of work or school life (b=1.01, CI=.57-1.47). However, military personnel were also significantly more likely than civilians to have sought care (PR=1.86, CI=1.53-2.25).
Military personnel reported a disproportionate amount of mental illness-related stigma, compared with Canadian civilians, and a greater impact of stigma. Nevertheless, military personnel were more likely to seek care, pointing to a complex relationship between stigma and care seeking in the military.
本研究旨在比较加拿大武装部队人员和加拿大平民中与精神疾病相关的耻辱感的患病率及其影响。
数据分别来自两项具有高度可比性的、基于人群的横断面调查,即2013年加拿大部队心理健康调查(N = 6696)和2012年加拿大社区健康调查 - 心理健康(N = 25113)。对在过去12个月内报告因心理健康问题寻求治疗的人群进行感知耻辱感评估。后续问题评估了耻辱感在各个领域的影响。采用修正泊松回归和线性回归来检验在寻求治疗、耻辱感和耻辱感影响方面的人群差异(军人与平民),并对社会人口学特征和护理需求进行了调整。
军人比平民更有可能感知到耻辱感(调整后的患病率比值[PR]=1.70,95%置信区间[CI]=1.11 - 2.60)。耻辱感对军人的影响更大,特别是在工作或学校生活方面(b = 1.01,CI =.57 - 1.47)。然而,军人比平民寻求治疗的可能性也显著更高(PR = 1.86,CI = 1.53 - 2.25)。
与加拿大平民相比,军人报告的与精神疾病相关的耻辱感比例过高,且耻辱感的影响更大。尽管如此,军人寻求治疗的可能性更高,这表明军队中耻辱感与寻求治疗之间存在复杂的关系。