King's Centre for Military Health Research, King's College London, London, United Kingdom.
Department of Psychological Medicine, Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, United Kingdom.
J Ment Health. 2023 Oct;32(5):962-984. doi: 10.1080/09638237.2022.2140792. Epub 2022 Nov 4.
In the UK military, adjustment disorder (AjD) is reported as one of the most diagnosed mental disorders, alongside depression, in personnel presenting to mental health services. Despite this, little is understood about what may predict AjD, common treatment or outcomes for this population.
The systematic review aimed to summarise existing research for AjD in Armed Forces (AF) populations, including prevalence and risk factors, and to outline clinical and occupational outcomes.
A literature search was conducted in December 2020 to identify research that investigated AjD within an AF population (serving or veteran) following the PRISMA guidelines.
Eighty-three studies were included in the review. The AjD prevalence estimates in AF populations with a mental disorder was considerably higher for serving AF personnel (34.9%) compared to veterans (12.8%). Childhood adversities were identified as a risk factor for AjD. AjD was found to increase the risk of suicidal ideation, with one study reporting a risk ratio of 4.70 (95% Confidence Interval: 3.50-6.20). Talking therapies were the most common treatment for AjD, however none reported on treatment effectiveness.
This review found that AjD was commonly reported across international AF. Despite heterogeneity in the results, the review identifies several literature gaps.
在英国军队中，适应障碍（AjD）被报告为心理健康服务机构中除抑郁症之外最常见的诊断精神障碍之一。尽管如此，对于可能预测 AjD 的因素、该人群的常见治疗方法或结果，人们知之甚少。
本系统综述旨在总结武装部队（AF）人群中 AjD 的现有研究，包括患病率和风险因素，并概述临床和职业结果。
按照 PRISMA 指南，于 2020 年 12 月进行文献检索，以确定研究 AjD 在 AF 人群（现役或退伍军人）中的研究。
该综述共纳入 83 项研究。患有精神障碍的现役 AF 人员的 AjD 患病率估计明显高于退伍军人（34.9%比 12.8%）。童年逆境被确定为 AjD 的一个风险因素。AjD 被发现会增加自杀意念的风险，一项研究报告的风险比为 4.70（95%置信区间：3.50-6.20）。谈话疗法是 AjD 的最常见治疗方法，但没有一项研究报告治疗效果。
本综述发现 AjD 在国际 AF 中较为常见。尽管结果存在异质性，但该综述确定了几个文献空白。
