Institute of Health and Wellbeing, University of Glasgow, Glasgow, UK
Institute of Health and Wellbeing, University of Glasgow, Glasgow, UK.
BMJ Mil Health. 2023 Jun;169(3):212-217. doi: 10.1136/bmjmilitary-2021-001786. Epub 2021 Apr 20.
It has been suggested that '' to the UK Armed Forces (prior to age 17.5 years) increases the risk of adverse mental health outcomes. We used data from a large cohort of veterans to examine long-term mental health outcomes in veterans by age at entry to the UK Armed Forces, compared with non-veterans.
Retrospective cohort study of 78 157 veterans in Scotland, born between 1945 and 1995 and and 252 637 matched non-veterans, with up to 37 years follow-up, using Cox proportional hazard models to examine the association between veteran status and cumulative risk of major mental health disorder, stratified by birth cohort, and age at recruitment for the veterans.
The risk of mental health disorder in the veterans increased with age at entry, ranging from HR 1.12, 95% CI 1.06 to 1.18, p<0.001 for junior entrants to HR 1.37, 95% CI 1.27 to 1.80, p<0.001 for those aged 20-25 years at entry. The pattern was most marked for veterans born before 1960, and age at recruitment had little impact in recent birth cohorts. Post-traumatic stress disorder accounted for most of the observed differences. Younger age at recruitment was associated with longer service, median 7.4 years (IQR 3.0-14.7) compared with 5.6 years (IQR 2.1-11.7) for entrants aged 20-25 years.
We found no evidence that early recruitment is associated with adverse impact on long-term mental health. Paradoxically, it was veterans who entered service at age 20-25 years who demonstrated increased risk, although this attenuated in more recent birth cohorts.
有人认为，“在 17.5 岁之前加入英国武装部队”会增加不良心理健康后果的风险。我们使用来自一个大型退伍军人队列的数据，通过与非退伍军人相比，按进入英国武装部队的年龄来检查退伍军人的长期心理健康结果。
苏格兰 78157 名退伍军人的回顾性队列研究，出生于 1945 年至 1995 年之间，与 252637 名匹配的非退伍军人相匹配，随访时间长达 37 年，使用 Cox 比例风险模型检查退伍军人身份与主要心理健康障碍累积风险之间的关联，按出生队列和退伍军人入伍年龄分层。
退伍军人的心理健康障碍风险随入伍年龄的增加而增加，从入伍年龄较小的 HR1.12（95%CI1.06-1.18，p<0.001）到入伍年龄为 20-25 岁的 HR1.37（95%CI1.27-1.80，p<0.001）。对于出生于 1960 年前的退伍军人，这种模式最为明显，而且最近的出生队列中入伍年龄的影响很小。创伤后应激障碍占观察到的差异的大部分。与入伍年龄较大的退伍军人相比，入伍年龄较小的退伍军人服役时间较长，中位数为 7.4 年（IQR3.0-14.7），而入伍年龄为 20-25 岁的退伍军人则为 5.6 年（IQR2.1-11.7）。
我们没有发现证据表明早期入伍与长期心理健康产生不良影响有关。矛盾的是，正是那些在 20-25 岁入伍的退伍军人表现出更高的风险，尽管在最近的出生队列中这种风险有所降低。
