Research and Knowledge Centre, Danish Defense Veteran Centre, 4100, Ringsted, Denmark.
Center for Clinical Research and Prevention, Bispebjerg and Frederiksberg Hospital, Capital Region, Nordre Fasanvej 57, 2000, Frederiksberg, Denmark.
Soc Psychiatry Psychiatr Epidemiol. 2019 Apr;54(4):497-506. doi: 10.1007/s00127-018-1648-1. Epub 2019 Jan 8.
Evidence exists of an association between pre-morbid lower cognitive ability and higher risk of hospitalization for depressive disorder in civilian cohorts. The purpose of this study was to examine the relationship of cognitive ability at conscription with post-deployment depression and the influence of (1) baseline factors: age, gender, and pre-deployment educational level, (2) deployment-related factors: e.g., war-zone stress and social support, and (3) co-morbid PTSD.
An observational cohort study linking conscription board registry data with post-deployment self-report data. The study population consisted of Danish Army military personnel deployed to different war zones from 1997 to 2015. The association between cognitive ability at conscription and post-deployment depression was analyzed using repeated-measure logistic regression models.
Study population totaled 9716 with a total of 13,371 deployments. Low-level cognitive ability at conscription was found to be weakly associated with post-deployment probable depression after adjustment for more important risk factors like gender, education, and deployment-related factors [odds ratio (OR) 0.93, 95% confidence interval (CI) 0.88-0.99]. The co-occurrence rate with PTSD was nearly 60%. When adding co-morbid PTSD as an independent variable, the association between cognitive ability and probable depression became insignificant, OR 0.95, CI 0.89-1.02.
Low cognitive ability at conscription is a risk factor for depression among returning military personnel, but unimportant compared to gender, education, and deployment-related factors. Part of this effect may be related to co-morbid PTSD. Use of cognitive ability score as an isolated selection tool cannot be recommended because of low predictive performance.
有证据表明，在平民队列中，发病前较低的认知能力与抑郁症住院风险较高之间存在关联。本研究的目的是检验入伍时的认知能力与部署后抑郁之间的关系，并探讨（1）基线因素：年龄、性别和入伍前教育水平，（2）与部署相关的因素：例如战区压力和社会支持，以及（3）共病 PTSD 的影响。
这是一项观察性队列研究，将征兵委员会登记数据与部署后自我报告数据相关联。研究人群由丹麦陆军军人组成，他们于 1997 年至 2015 年期间部署到不同的战区。使用重复测量逻辑回归模型分析入伍时的认知能力与部署后抑郁之间的关联。
研究人群总计 9716 人，共有 13371 次部署。在调整性别、教育和与部署相关的因素等更重要的风险因素后，入伍时认知能力较低与部署后可能的抑郁之间存在弱关联[比值比（OR）0.93，95%置信区间（CI）0.88-0.99]。共病 PTSD 的发生率接近 60%。当将共病 PTSD 作为一个独立变量加入时，认知能力与可能的抑郁之间的关联变得不显著，OR 0.95，CI 0.89-1.02。
入伍时认知能力较低是退伍军人抑郁的一个风险因素，但与性别、教育和与部署相关的因素相比，这一因素并不重要。部分影响可能与共病 PTSD 有关。由于预测性能较低，不能推荐使用认知能力得分作为孤立的选择工具。
