Lifetime Prevalence and Comorbidity of Mental Disorders in the Two-wave 2002-2018 Canadian Armed Forces Members and Veterans Mental Health Follow-up Survey (CAFVMHS): Prévalence et Comorbidité de Durée de vie Des Troubles Mentaux Dans l'Enquête de Suivi Sur la Santé Mentale Auprès des Membres des Forces Armées Canadiennes et Des ex-Militaires (ESSMFACM) en Deux Cycles de 2002 à 2018.

Jitender Sareen,James M Bolton,Charles N Bernstein,Shay-Lee Bolton,Mary Beth Maclean,Tracie O Afifi,Tamara Taillieu,Gordon J G Asmundson,Natalie Mota,Linda Vantil,J Don Richardson,Renée El-Gabalawy,Jianli Wang,Ruth Ann Marrie,Ashley Stewart-Tufescu,Murray W Enns,Murray B Stein,Sarvesh Logsetty,James M Thompson

doi:10.1177/07067437211000636

Abstract

Objective:The current study used the Canadian Armed Forces Members and Veterans Mental Health Follow-up Survey (CAFVMHS) to (1) examine the incidence and prevalence of mental disorders and (2) estimate the comorbidity of mental disorders over the follow-up period.Method:The CAFVMHS (2018) is a longitudinal study with two time points of assessment. The sample is comprised of 2,941 Canadian Forces members and veterans who participated in the 2002 Canadian Community Health Survey: Canadian Forces Supplement. The World Health Organization Composite International Diagnostic Interview (WHO-CIDI) was utilized to diagnose Diagnostic and Statistical Manual-IV post-traumatic stress disorder (PTSD), major depressive episode (MDE), generalized anxiety disorder, social anxiety disorder (SAD), and alcohol abuse and dependence. Self-report health professional diagnoses were assessed for attention deficit hyperactivity disorder (ADHD), mania, obsessive compulsive disorder (OCD), and personality disorder. We established weighted prevalence of mental disorders and examined the association between mental disorders using logistic regression.Results:In 2018, lifetime prevalence of any WHO-CIDI-based or self-reported mental disorder was 58.1%. Lifetime prevalence of any mood or anxiety disorder or PTSD was 54.0% in 2018. MDE (39.9%), SAD (25.7%), and PTSD (21.4%) were the most common mental disorders. There was a substantial increase in new onset or recurrence/persistence of mental disorders between the two measurement points (16-year assessment gap); 2002–2018 period prevalences were 43.5% for mood and anxiety disorder and 16.8% for alcohol abuse or dependence. The prevalence of self-reported ADHD, OCD, any personality disorder, and mania were 3.3%, 3.0%, 0.8%, and 0.8%, respectively. Comorbidity between mental disorders increased over the follow-up.Conclusions:This study demonstrates a high burden of mental disorders among a large Canadian military and veteran cohort. These findings underscore the importance of prevention and intervention strategies to reduce the burden of mental disorders and alcohol use disorders in these populations.

Highlights

This study demonstrates a high burden of mental disorders among a large Canadian military and veteran cohort
Les diagnostics auto-verifies par des professionnels de la santeont eteevalues pour le trouble de deficit d’attention avec hyperactivite (TDAH), la manie, le trouble obsessionnel-compulsif (TOC), et le trouble de la personnalite
Canadian military members and veterans have been noted to have a higher prevalence of mental disorders than

Summary

Results

In 2018, the cumulative lifetime prevalence of at least 1 mood or anxiety disorder was 54%. MDE, SAD, and PTSD were the 3 most common conditions with 2018 lifetime prevalence of 40.0%, 25.8, and 22.0%. All mood and anxiety disorders had a substantial increase in prevalence, often more than doubling. Comorbidity between mental disorders increased over time (3 or more disorders—2002: 1.7%, 2018: 10.6%). PTSD, GAD, panic disorder, and SAD all had high rates of comorbidity among those reporting a MDE (ranging from 73% to 83%)

Conclusions

Method

Disorders

Strengths and Limitations