Retrospective age-of-onset and projected lifetime prevalence of psychiatric disorders among U.S. Army National Guard soldiers.
The study of military-related mental health has been disproportionately focused on current symptomology rather than potentially more informative life course mental health. Indeed, no study has assessed age-of-onset and projected lifetime prevalence of disorders among reservists.



Age-of-onset and projected lifetime DSM-IV anxiety, mood, and substance use disorders were assessed in 671 Ohio Army National Guard soldiers aged 17-60 years. Between 2008 and 2012, face-to-face clinical assessments and surveys were conducted using the Structured Clinical Interview for DSM-IV and Clinician-Administered PTSD Scale.



Lifetime prevalence of psychiatric disorders was 61%. Alcohol abuse/dependence (44%) and major depressive disorder (23%) were the most common disorders. The majority (64%) of participants reported disorders antedating enlistment. Median age-of-onset varied with anxiety disorders - particularly phobias and OCD - having the earliest (median=15 years) and mood disorders the latest median age-of-onset (median=21 years).



The study was limited by both the retrospective investigation of age-of-onset and the location of our sample. As our sample may not represent the general military population, our findings need to be confirmed in additional samples.



Each psychiatric disorder exhibited a distinct age-of-onset pattern, such that phobias and OCD onset earliest, substance use disorders onset during a short interval from late-adolescence to early-adulthood, and mood disorders onset the latest. Our finding that the majority of participants reported disorders antedating enlistment suggests that an assessment of lifetime psychopathology is essential to understanding the mental health burden of both current and former military personnel.
Department of Epidemiology, Columbia University, New York, NY, United States. Electronic address: dsf2130@columbia.edu.
David S
DS
Fink
Department of Psychiatry, Case Western University, Cleveland, OH, United States.
Joseph R
JR
Calabrese
Department of Psychiatry, University of Michigan, Ann Arbor, MI, United States.
Israel
I
Liberzon
Department of Psychiatry, University of Toledo, Toledo, OH, United States.
Marijo B
MB
Tamburrino
Department of Psychiatry, University of Toledo, Toledo, OH, United States.
Philip
P
Chan
Department of Epidemiology, Columbia University, New York, NY, United States.
Greg H
GH
Cohen
Department of Epidemiology, Boston University, Boston, MA, United States.
Laura
L
Sampson
Biomedical Research Informatics Core, Michigan State University, United States.
Philip L
PL
Reed
Department of Psychiatry, Case Western University, Cleveland, OH, United States.
Edwin
E
Shirley
Department of Psychiatry, Case Western University, Cleveland, OH, United States.
Toyomi
T
Goto
Department of Psychiatry, Case Western University, Cleveland, OH, United States.
Nicole
N
D'Arcangelo
Department of Psychiatry, University of Toledo, Toledo, OH, United States.
Thomas
T
Fine
School of Public Health, Boston University, Boston, MA, United States.
Sandro
S
Galea
D000293:Adolescent; D000328:Adult; D000367:Age Factors; D017668:Age of Onset; D001008:Anxiety Disorders / Q000453:epidemiology; D003865:Major Depressive Disorder / Q000453:epidemiology; D039721:Diagnostic and Statistical Manual of Mental Disorders; D005260:Female; D006801:Humans; D008297:Male; D001523:Mental Disorders / Q000453:epidemiology*; D008603:Mental Health / Q000706:statistics & numerical data*; D008875:Middle Aged; D008889:Military Personnel / Q000523:psychology* / Q000706:statistics & numerical data; D019964:Mood Disorders / Q000453:epidemiology; D015995:Prevalence; D012189:Retrospective Studies; D014481:United States / Q000453:epidemiology
Age-of-onset; Military medicine; Military personnel; Psychiatric disorder