A rapid review of literature on first episode psychosis among United States military service members

Abstract

ABSTRACT Background Current literature does not thoroughly examine the development or treatment of first episode psychosis (FEP) among active duty service members. Methods We conducted a rapid review on demographics, epidemiology, assessment, and intervention for FEP among service members. The final dataset contained eight peer-reviewed articles published between 2011 and 2021. Results Incidence of FEP among service members ranged from 1.4 to 2.3 for schizophrenia and 5.6 to 9.3 for other psychotic disorders per 10,000 person-years. Risk factors for developing psychosis during active duty service included distance of the place of service to home, multiple substance use, birthplace or place of residence in small towns or large cities, psychosocial stress, placement in an Army service branch or motor transport occupation, and more than one visit to mental health providers in the year before diagnosis. Racial minority status, younger age, less education, lower military grade, less time spent in service, and never-married status were also associated with higher risk of FEP. Conclusion Enhancing screening procedures before and after military entrance, reducing the impact of psychosocial stress during military initiation, and providing early, multimodal treatment for FEP would likely improve health outcomes for service members and reduce burden on the Military Health System.