Age at entry to UK military service and long-term mental health

Bergman, B. P., Mackay, D.F. , Fear, N.T. and Pell, J.P. (2021) Age at entry to UK military service and long-term mental health. BMJ Military Health, (doi: 10.1136/bmjmilitary-2021-001786) (PMID:33879527) (Early Online Publication)

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Abstract

Introduction: It has been suggested that ‘junior entry’ to the UK Armed Forces (prior to age 17.5 years) increases the risk of adverse mental health outcomes. We used data from a large cohort of veterans to examine long-term mental health outcomes in veterans by age at entry to the UK Armed Forces, compared with non-veterans. Methods: Retrospective cohort study of 78 157 veterans in Scotland, born between 1945 and 1995 and and 252 637 matched non-veterans, with up to 37 years follow-up, using Cox proportional hazard models to examine the association between veteran status and cumulative risk of major mental health disorder, stratified by birth cohort, and age at recruitment for the veterans. Results: The risk of mental health disorder in the veterans increased with age at entry, ranging from HR 1.12, 95% CI 1.06 to 1.18, p<0.001 for junior entrants to HR 1.37, 95% CI 1.27 to 1.80, p<0.001 for those aged 20–25 years at entry. The pattern was most marked for veterans born before 1960, and age at recruitment had little impact in recent birth cohorts. Post-traumatic stress disorder accounted for most of the observed differences. Younger age at recruitment was associated with longer service, median 7.4 years (IQR 3.0–14.7) compared with 5.6 years (IQR 2.1–11.7) for entrants aged 20–25 years. Conclusion: We found no evidence that early recruitment is associated with adverse impact on long-term mental health. Paradoxically, it was veterans who entered service at age 20–25 years who demonstrated increased risk, although this attenuated in more recent birth cohorts.

Item Type:Articles
Status:Early Online Publication
Refereed:Yes
Glasgow Author(s) Enlighten ID:Pell, Professor Jill and Bergman, Dr Beverly and Mackay, Professor Daniel
Authors: Bergman, B. P., Mackay, D.F., Fear, N.T., and Pell, J.P.
College/School:College of Medical Veterinary and Life Sciences > Institute of Health and Wellbeing > General Practice and Primary Care
College of Medical Veterinary and Life Sciences > Institute of Health and Wellbeing > Public Health
Journal Name:BMJ Military Health
Publisher:BMJ Publishing Group
ISSN:2633-3767
ISSN (Online):2633-3775
Published Online:20 April 2021
Copyright Holders:Copyright © 2021 The Authors
First Published:First published in BMJ Military Health 2021
Publisher Policy:Reproduced under a Creative Commons License
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Project CodeAward NoProject NamePrincipal InvestigatorFunder's NameFunder RefLead Dept
302109Trends in Scottish Veterans' HealthBeverly BergmanForces in Mind Trust (FiMT) (FIMT)FiMT17/1101UGHW - Public Health