Boscarino Joseph A, Adams Richard E, Urosevich Thomas G, Hoffman Stuart N, Kirchner H Lester, Boscarino Joseph J, Withey Carrie A, Dugan Ryan J, Figley Charles R
Department of Epidemiology and Health Services Research, Geisinger Clinic, Danville, PA.
Department of Sociology, Kent State University, Kent, OH.
J Nerv Ment Dis. 2018 Oct;206(10):757-764. doi: 10.1097/NMD.0000000000000879.
We examined the effects of homecoming support on current mental health among 1730 deployed veterans from Vietnam, Iraq/Afghanistan, Persian Gulf, and other conflicts. The prevalence of current posttraumatic stress disorder (PTSD) was 5.4%, current depression was 8.3%, and 5.4% had suicidal thoughts in the past month. Overall, 26% of veterans had low homecoming support, which was more prevalent among Vietnam veterans (44.3%, p < 0.001). In multivariable logistic regressions, controlling for demographics, combat exposure, number of deployments, trauma history, and operational theater, low postdeployment support was associated with PTSD (odds ratio, 2.13; p = 0.032) and suicidality (odds ratio, 1.91; p < 0.030), but not depression. For suicidality, an interaction was detected for homecoming by theater status, whereby Iraq/Afghanistan veterans with lower homecoming support had a higher probability of suicidal thoughts (p = 0.002). Thus, years after deployment, lower homecoming support was associated with current PTSD and suicidality, regardless of theater and warzone exposures. For suicidality, lower support had a greater impact on Iraq/Afghanistan veterans.
我们研究了返乡支持对1730名曾被部署到越南、伊拉克/阿富汗、波斯湾及其他冲突地区的退伍军人当前心理健康状况的影响。当前创伤后应激障碍(PTSD)的患病率为5.4%,当前抑郁症患病率为8.3%,在过去一个月中有自杀念头的比例为5.4%。总体而言,26%的退伍军人获得的返乡支持较低,这在越南退伍军人中更为普遍(44.3%,p<0.001)。在多变量逻辑回归分析中,在控制了人口统计学因素、战斗经历、部署次数、创伤史和作战地区后,部署后支持较低与PTSD(比值比,2.13;p = 0.032)和自杀倾向(比值比,1.91;p<0.030)相关,但与抑郁症无关。对于自杀倾向,发现返乡支持与战区状况之间存在交互作用,即返乡支持较低的伊拉克/阿富汗退伍军人有更高的自杀念头概率(p = 0.002)。因此,在部署多年后,无论战区和作战区域暴露情况如何,较低的返乡支持都与当前的PTSD和自杀倾向相关。对于自杀倾向,较低的支持对伊拉克/阿富汗退伍军人的影响更大。