title: Epidemiology of psychiatric disability without posttraumatic stress disorder among U.S. Army and Marine Corps personnel evaluated for disability discharge.
abstract: Psychiatric disorders are a common reason for disability discharge from the U.S. military. Research on psychiatric disorders in military personnel evaluated for disability discharge has historically focused on posttraumatic stress disorder (PTSD), yet 40% of service members evaluated for a psychiatric-related disability do not have PTSD. This study's objective was to describe characteristics and correlates of disability in Army and Marine Corps personnel diagnosed with psychiatric disorders other than PTSD. In this cross-sectional study, the chi-square and Wilcoxon-Mann-Whitney tests compared the distribution of demographic, disability and deployment characteristics between those evaluated for non-PTSD psychiatric disability (N = 9125) versus those evaluated for any other non-psychiatric condition (N = 78,072). Multivariate logistic regression examined associations between disability retirement and demographic and disability characteristics. Results show a significantly higher prevalence of disability retirement, deployment, and comorbidity among Army and Marine Corps personnel evaluated for disability discharge related to a non-PTSD psychiatric disorder. Mood disorders, anxiety disorders and dementia were the most commonly evaluated psychiatric disorders. Characteristics associated with increased odds of non-PTSD psychiatric-related disability retirement includes being in the Marine Corps (OR = 1.24), being black (OR = 1.29) or other race (OR = 1.33), having a combat-related condition (OR = 2.50), and older age. Service members evaluated for a non-PTSD psychiatric disability have similar rates of disability retirement as those evaluated for PTSD, suggesting non-PTSD psychiatric disorders cause a severe and highly compensated disability. Additional research is needed describing the epidemiology of specific non-PTSD psychiatric disorders, such as depression, in service members evaluated for disability discharge.
authors.affiliation: Department of Epidemiology, Preventive Medicine Branch, Walter Reed Army Institute of Research, 503 Robert Grant Avenue, Silver Spring, MD 20910, USA; ManTech International Corporation, Health and Life Sciences, 13755 Sunrise Valley Drive, Herndon, VA 20171, USA. Electronic address: amanda.l.piccirillo.ctr@mail.mil.
authors.forename: Amanda L
authors.initials: AL
authors.lastname: Piccirillo
authors.affiliation: Department of Epidemiology, Preventive Medicine Branch, Walter Reed Army Institute of Research, 503 Robert Grant Avenue, Silver Spring, MD 20910, USA; ManTech International Corporation, Health and Life Sciences, 13755 Sunrise Valley Drive, Herndon, VA 20171, USA.
authors.forename: Elizabeth R
authors.initials: ER
authors.lastname: Packnett
authors.affiliation: Department of Epidemiology, Preventive Medicine Branch, Walter Reed Army Institute of Research, 503 Robert Grant Avenue, Silver Spring, MD 20910, USA.
authors.forename: Michael R
authors.initials: MR
authors.lastname: Boivin
authors.affiliation: Department of Epidemiology, Preventive Medicine Branch, Walter Reed Army Institute of Research, 503 Robert Grant Avenue, Silver Spring, MD 20910, USA; ManTech International Corporation, Health and Life Sciences, 13755 Sunrise Valley Drive, Herndon, VA 20171, USA.
authors.forename: David N
authors.initials: DN
authors.lastname: Cowan
mesh_terms: D000328:Adult; D000367:Age Factors; D001008:Anxiety Disorders / Q000453:epidemiology*; D003430:Cross-Sectional Studies; D005260:Female; D006801:Humans; D008297:Male; D008889:Military Personnel / Q000706:statistics & numerical data*; D015995:Prevalence; D014481:United States; D000067453:War Exposure / Q000706:statistics & numerical data; D055815:Young Adult
keywords: Disability; Epidemiology; Military psychiatry