Psychosis in the British Army: a 2-year follow-up study.
BACKGROUND
Recent research into mental illness in military populations has tended to focus on minor mental illness and the consequences of trauma. The literature contains very little on serious mental illness, including its occupational implications.


OBJECTIVE
To identify the incidence and factors associated with nonaffective psychosis in British Army personnel, to evaluate service quality in terms of duration of untreated psychosis, and to identify predictors of occupational outcome after 2 years, to inform future management of similar cases.


METHODS
A retrospective study of the case notes of all Army personnel admitted to the U.K. military psychiatric inpatient facility in Catterick Garrison with a nonaffective psychosis over a 4-year period between 1999 and 2002 was performed.


RESULTS
There were 48 cases of nonaffective psychosis and 14 cases of schizophrenia, corresponding to mean annual incidences of 0.11 cases per 1,000 and 0.03 cases per 1,000, respectively. The mean duration of untreated psychosis was 11 months, and 29 cases (60%) were diagnosed and treated in < 4 months. Officer status and longer duration of service predicted retention. Only eight patients (16.7%) were still in service at 2 years.


CONCLUSIONS
These findings indicate (1) there is a low incidence of nonaffective psychosis, (2) the military performs well in early detection and intervention in psychosis, and (3) a well-established military career and the premorbid psychological stability this implies predict a good occupational outcome.
Turner
Mark A
MA
University Hospital of North Tees, Hardwick, Stockton on Tees, TS19 8PE, England.
Finch
Peter J C
PJ
McKechanie
Andrew G
AG
Kiernan
Mathew D
MD
Hawksley
Oliver J
OJ
Wadhwani
Sharan
S
McManus
Frank B
FB
Neal
Leigh A
LA
D000293:Adolescent; D000328:Adult; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D015994:Incidence; D008297:Male; D008889:Military Personnel / Q000523:psychology*; D008890:Military Psychiatry; D009784:Occupational Diseases / Q000175:diagnosis / Q000453:epidemiology* / Q000523:psychology; D011618:Psychotic Disorders / Q000175:diagnosis / Q000453:epidemiology*; D012189:Retrospective Studies; D018570:Risk Assessment; D012307:Risk Factors; D012559:Schizophrenia / Q000453:epidemiology; D013997:Time Factors; D006113:United Kingdom / Q000453:epidemiology; D014938:Work Capacity Evaluation