Common mental disorders prevalent in UK military « King’s College London
Symptoms of anxiety and depression appear to be twice as frequent in the UK military as in the general working population, according to research carried out at the King’s Centre for Military Health Research (KCMHR), King’s College London and published in Psychological Medicine.
The study compared data from over 7,000 personnel serving in the UK Armed Forces with 7,000 people from the general population identified as being in employment from the Health Survey for England. Both surveys used the General Health Questionnaire (GHQ) and it was found that symptoms of common mental disorders (CMD) (i.e. anxiety and depression), appeared to be twice as frequent in the military as in the general working population. In fact, 18% of men and 25% of women serving in the Armed Forces reported symptoms of CMD compared to 8% of men and 12% of women in the general working population. This difference was apparent at both time points of the study, 2003 and 2008.
Lead author, Dr Laura Goodwin from KCMHR said ‘This is the first formal comparison of common mental disorders between the serving military and the general working population. Whilst symptoms of common mental disorders appear to be twice as common in the military after accounting for age, gender and social class, there is more to be done to understand these differences.’
The researchers had previously found that there is a tendency for over reporting of symptoms of anxiety and depression in occupational studies aimed at specific groups such as police, teachers and social workers. The Health Survey for England was a population study in which an individual’s occupation was not the main focus, which is likely to have had some effect on the results.
One way it was a considerable improvement on earlier research was that previous studies have all been forced to compare different measures of CMD, which is a major limitation, whereas in this study all participants completed the same questionnaire, the GHQ. Also, some previous surveys have included individuals who are unemployed and those with long-term health problems and disabilities and these groups are more likely to report symptoms of depression and anxiety, so this comparison of military employees with only those in employment from the general population is a fairer like-for-like comparison.
The survey included questions such as whether the subject felt they were ‘playing a useful part in things’, and military respondents were almost three times more likely to disagree with this statement than the general population at both time points. On the other hand, the smallest difference between the military and general population was found for the statement ‘felt constantly under strain’.
The researchers suggest that differences in the prevalence of symptoms of depression and anxiety in this extensive study could be explained by the frequency and intensity of stressful events experienced by military personnel and that military life requires extended periods spent away from family and friends, for training and exercises as well as for deployment.
Professor Nicola Fear, KCMHR concludes: ‘This highlights that symptoms of depression and anxiety are common in the Armed Forces, in fact, they are more common than alcohol misuse or post-traumatic stress disorder (PTSD). The findings draw attention to the need for Defence Medical Services to continue to focus on identifying and treating depression and anxiety in addition to PTSD.’
Paper reference: Goodwin, L. et al. ‘Are common mental disorders more prevalent in the UK serving military compared to the general working population?’ published in Psychological Medicine DOI: http://dx.doi.org/10.1017/S0033291714002980