Temporal Assessment of Mental Disorders, Smoking, and Hazardous Drinking in United States Troops Deployed in Support of the Operations in Iraq and Afghanistan
NAVAL HEALTH RESEARCH CENTER SAN DIEGO CA
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Combat exposure is known to increase the risk for mental disorders. However, little is known about the temporal relationship between mental disorders and alcohol or smoking. A positive screen for a mental disorder at baseline or follow-up was associated with increased risk for newly reported hazardous drinking and relapse of smoking among past smokers. Among service members who screened negative for a mental disorder and did not report hazardous drinking or smoking at baseline, those who screened positive for a new-onset mental disorder at follow-up were also 1.51 times 95 confidence interval CI, 1.28-1.78 and 2.64 times 95 CI, 2.20-3.14 more likely to report new smoking and new hazardous drinking, respectively. Differentiating by recent deployment status and including all services as well as active duty and ReserveNational Guard members, this study demonstrates that multiple temporal sequence patterns exist to explain the relationship between mental disorders and hazardous drinking and smoking, and these patterns are not easily distinguished by demographic or behavioral characteristics. Clinical approaches to mitigate deployment-related mental disorders should include alcohol and tobacco-related assessment and intervention.