title: Alcohol misuse and functional impairment in the UK Armed Forces: a population-based study.
abstract: OBJECTIVE
  To assess whether alcohol misuse was associated with functional impairment in the military, and whether an association between any of the measures of alcohol misuse and impairment would be explained by psychiatric comorbidity.
  
  
  METHODS
  Large cross-sectional study.
  
  
  METHODS
  8585 responders of a random sample of the regular United Kingdom Armed Forces who completed a questionnaire in 2005 were included in the analyses.
  
  
  METHODS
  Five items of the Short Form Questionnaire-36 (SF-36) specifically dealing with functional impairment, and the main independent variable was alcohol misuse based on the Alcohol Use Disorders Identification Test (AUDIT).
  
  
  RESULTS
  An AUDIT score of > or = 20 was consistently associated with impairment with odds ratios between 1.8 (95% confidence interval 1.4-2.3) and 3.7 (2.8-4.8). AUDIT scores <20 did not increase impairment. Those with a hazardous pattern of drinking (AUDIT score 8-15) perceived their functioning to be better than those with an AUDIT score <8. A score indicating alcohol dependence was associated with impairment, as, to a lesser extent, was alcohol related-harm. Binge drinking was not associated with impairment. Half of those with an AUDIT score of > or = 20 had psychological comorbidities.
  
  
  CONCLUSIONS
  Perception of impairment was mainly related to those with an AUDIT score of > or = 20 or more, those who had an indication of alcohol dependence or alcohol related-harm. Intervention on an individual basis should be focused on these groups, while effective public health interventions could be enhanced for everyone.
authors.affiliation: King's College London, King's Centre for Military Health Research, Weston Education Centre, London SE5 9RJ, UK. Roberto.rona@iop.kcl.ac.uk
authors.forename: Roberto J
authors.initials: RJ
authors.lastname: Rona
authors.forename: Margaret
authors.initials: M
authors.lastname: Jones
authors.forename: Nicola T
authors.initials: NT
authors.lastname: Fear
authors.forename: Lisa
authors.initials: L
authors.lastname: Hull
authors.forename: Matthew
authors.initials: M
authors.lastname: Hotopf
authors.forename: Simon
authors.initials: S
authors.lastname: Wessely
mesh_terms: D000328:Adult; D000367:Age Factors; D000437:Alcoholism / Q000453:epidemiology*; D003130:Combat Disorders / Q000523:psychology; D015897:Comorbidity; D004493:Education; D005260:Female; D006304:Health Status; D006801:Humans; D016015:Logistic Models; D008297:Male; D017533:Marital Status; D001523:Mental Disorders / Q000150:complications / Q000523:psychology; D008889:Military Personnel / Q000706:statistics & numerical data*; D016017:Odds Ratio; D011363:Professional Impairment / Q000523:psychology*; D012919:Social Behavior; D012959:Socioeconomic Factors; D013313:Stress Disorders, Post-Traumatic / Q000150:complications / Q000523:psychology; D011795:Surveys and Questionnaires; D006113:United Kingdom / Q000453:epidemiology; D055815:Young Adult