title: Military hierarchy, job stress and mental health in peacetime.
abstract: BACKGROUND
  Most studies of mental health in the armed forces focus primarily on post-traumatic stress disorders among military personnel in combat situations.
  
  
  OBJECTIVE
  To evaluate the prevalence of common mental disorders (CMD) and job stress, and the association between the two, among military personnel in peacetime. Additionally, it sought to identify occupational subgroups with higher prevalences of CMD.
  
  
  METHODS
  The study participants were 506 military personnel from a Brazilian army directorate in Rio de Janeiro City. CMD were evaluated using the 12-item version General Health Questionnaire. Job characteristics were measured using the effort-reward imbalance (ERI) model and by categories of military rank. Prevalence ratios (PRs) were estimated by Poisson regression to obtain robust (95%) confidence intervals (CIs).
  
  
  RESULTS
  The prevalence of CMD was 33% (95% CI 29-37). After adjusting for age, education, income, lifestyle and other occupational characteristics, ERI was associated with CMD (PR = 2.03; 95% CI 1.3-3.1). Overcommitment proved to be an important component of job stress. Independently of socio-economic, demographic, lifestyle and job stress variables, the rank of lieutenant associated strongly with CMD (PR = 2.02; 95% CI 1.2-4 0.1).
  
  
  CONCLUSIONS
  This study found that job stress among armed forces personnel is associated with CMD. In addition, the specific occupational characteristics of the military environment can lead to a higher prevalence of CMD among those holding the rank of lieutenant.
authors.affiliation: Department of Epidemiology, Institute of Social Medicine, State University of Rio de Janeiro (IMS/UERJ), Rua São Francisco Xavier 524, Rio de Janeiro, RJ 20550-900, Brazil. lilitina@gmail.com
authors.forename: L C X
authors.initials: LC
authors.lastname: Martins
authors.forename: C S
authors.initials: CS
authors.lastname: Lopes
mesh_terms: D000328:Adult; D001938:Brazil / Q000453:epidemiology; D003430:Cross-Sectional Studies; D004522:Educational Status; D006801:Humans; D008297:Male; D001523:Mental Disorders / Q000453:epidemiology*; D008875:Middle Aged; D008889:Military Personnel / Q000523:psychology*; D008962:Models, Theoretical; D009790:Occupations; D013315:Stress, Psychological / Q000453:epidemiology*; D055815:Young Adult