title: Alcohol misuse in the United Kingdom Armed Forces: A longitudinal study.
abstract: OBJECTIVE
  We assessed changes in Alcohol Use Disorders Identification Test (AUDIT) scores over time. We investigated the impact of life events and changes in mental health status on AUDIT scores over time in UK military personnel.
  
  
  METHODS
  A random representative sample of regular UK military personnel who had been serving in 2003 were surveyed in 2004-2006 (phase 1) and again in 2007-2009 (phase 2). The impact of changes in symptoms of psychological distress, probable post-traumatic stress disorder (PTSD), marital status, serving status, rank, deployment to Iraq/Afghanistan and smoking was assessed between phases.
  
  
  RESULTS
  We found a statistically significant but small decrease in AUDIT scores between phases 1 and 2 (mean change=-1.01, 95% confidence interval=-1.14, -0.88). Participants reported a decrease in AUDIT scores if they experienced remission in psychological distress (adjusted mean -2.21, 95% CI -2.58, -1.84) and probable PTSD (adjusted mean -3.59, 95% CI -4.41, -2.78), if they stopped smoking (adjusted mean -1.41, 95% CI -1.83, -0.98) and were in a new relationship (adjusted mean -2.77, 95% CI -3.15, -2.38). On the other hand, reporting new onset or persistent symptoms of probable PTSD (adjusted mean 1.34, 95% CI 0.71, 1.98) or a relationship breakdown (adjusted mean 0.53, 95% CI 0.07, 0.99) at phase 2 were associated with an increase in AUDIT scores.
  
  
  CONCLUSIONS
  The overall level of hazardous alcohol consumption remains high in the UK military. Changes in AUDIT scores were linked to mental health and life events but not with deployment to Iraq or Afghanistan.
authors.affiliation: Academic Department of Military Mental Health, King's College London, London, UK; King's Centre for Military Health Research, King's College London, London, UK. Electronic address: gursimran.thandi@kcl.ac.uk.
authors.forename: Gursimran
authors.initials: G
authors.lastname: Thandi
authors.affiliation: Academic Department of Military Mental Health, King's College London, London, UK.
authors.forename: Josefin
authors.initials: J
authors.lastname: Sundin
authors.affiliation: Academic Department of Military Mental Health, King's College London, London, UK.
authors.forename: Terry
authors.initials: T
authors.lastname: Ng-Knight
authors.affiliation: King's Centre for Military Health Research, King's College London, London, UK.
authors.forename: Margaret
authors.initials: M
authors.lastname: Jones
authors.affiliation: King's Centre for Military Health Research, King's College London, London, UK.
authors.forename: Lisa
authors.initials: L
authors.lastname: Hull
authors.affiliation: Academic Department of Military Mental Health, King's College London, London, UK.
authors.forename: Norman
authors.initials: N
authors.lastname: Jones
authors.affiliation: Academic Department of Military Mental Health, King's College London, London, UK.
authors.forename: Neil
authors.initials: N
authors.lastname: Greenberg
authors.affiliation: King's Centre for Military Health Research, King's College London, London, UK.
authors.forename: Roberto J
authors.initials: RJ
authors.lastname: Rona
authors.affiliation: King's Centre for Military Health Research, King's College London, London, UK.
authors.forename: Simon
authors.initials: S
authors.lastname: Wessely
authors.affiliation: King's Centre for Military Health Research, King's College London, London, UK.
authors.forename: Nicola T
authors.initials: NT
authors.lastname: Fear
mesh_terms: D000328:Adult; D055826:Afghan Campaign 2001-; D000437:Alcoholism / Q000453:epidemiology*; D015331:Cohort Studies; D005260:Female; D006801:Humans; D054542:Iraq War, 2003-2011; D008137:Longitudinal Studies; D008297:Male; D008603:Mental Health; D008875:Middle Aged; D008889:Military Personnel / Q000706:statistics & numerical data*; D012907:Smoking / Q000009:adverse effects / Q000523:psychology; D012959:Socioeconomic Factors; D013313:Stress Disorders, Post-Traumatic / Q000150:complications / Q000523:psychology; D011795:Surveys and Questionnaires; D006113:United Kingdom / Q000453:epidemiology; D055815:Young Adult
keywords: AUDIT; Alcohol misuse; Longitudinal study; Military; Post-traumatic stress disorder (PTSD); Psychological distress; Relationship status; Smoking; UK