Mental health outcomes and alcohol consumption among UK military spouses/partners: a comparison with women in the general population

Figures & data

Figure 1. Flow diagram of Children of Military Fathers Study participants.

Table 1. Socio-demographic and military affiliations of military spouses/partners compared to women in the APMS and the KCMHR cohort study.

Socio-demographic characteristics	S/Ps % (n)	APMS % (n)	X^2	df	p value
Age (years)	N = 405	N = 1594
25–34	27.5 (100)	24.6 (386)
35–44	50.7 (202)	39.4 (644)
45–55	21.8 (90)	36.0 (564)	12.25	2	<0.001
Relationship status
Married	86.4 (337)	66.2 (912)
Cohabiting	10.2 (28)	12.0 (168)
Other	3.4 (11)	21.9 (514)	23.59	2	<0.001
Number of children
1	49.5 (192)	25.6 (419)
2+	50.5 (213)	74.4 (1175)	42.49	1	<0.001
Social occupational class
Managerial/professional	24.1 (88)	33.0 (494)
Intermediate	28.7 (106)	17.6 (261)
Routine/manual	17.5 (62)	27.1 (414)
Unemployed/never worked	29.7 (113)	22.4 (370)	12.20	3	<0.001
Personnel military characteristics	S/Ps % (n)	KCMHR cohort % (n)	X^2	df	p value
Service
Royal Navy	13.1 (50)	13.3 (1008)
Royal Marines	5.6 (21)	3.1 (350)
Army	64.4 (260)	64.3 (5764)
Royal Air Force	16.9 (74)	19.3 (1677)	2.25	3	0.083
Rank
Officers	19.9 (106)	19.2 (1869)
NCOs	68.1 (254)	61.3 (4902)
Other ranks	12.0 (45)	19.5 (2028)	6.72	2	0.001
Engagement type
Regular	86.9 (348)	90.1 (7413)
Reserve	13.1 (56)	9.9 (1386)	4.30	1	0.038
Serving status
Still serving	61.9 (255)	73.6 (6799)
No longer in Service	38.1 (150)	26.4 (1979)	21.47	1	<0.001
Length of service
0–9 years	15.0 (57)	34.3 (3494)
10–22 years	55.3 (207)	44.5 (3401)
>22years	29.8 (127)	21.2 (1588)	28.39	2	<0.001
Experience of combat role
No combat role	79.4 (326)	76.8 (6728)
Combat role	20.6 (79)	23.2 (2071)	1.15	1	0.283
Experience of Iraq/Afghanistan deployment
No deployment	39.7 (170)	38.5 (2580)
Deployed	60.3 (235)	61.5 (6219)	0.20	1	0.652
Experience of family separation
No experience	24.7 (101)	–
>1 month	34.8 (150)	–
2–4 months	20.8 (81)	–
> 5 months	19.7 (67)	–	–	–	–

Missing n = 13–502.

Table 2. Prevalence of mental health and alcohol outcomes among military spouses/partners compared to women in the general population (%, N, unadj., adj. ORs).

Mental health outcomes	S/Ps % (N) N = 405	APMS % (N) N = 1594	Unadj. OR (95% CI)^a	Adj. OR (95% CI)	p value
Probable depression (PHQ-9)
No/mild depression	92.9 (366)	96.8 (1531)	1.0	1.0^b
Moderate/severe depression	7.2 (28)	3.2 (63)	2.34 (1.43–3.82)	2.50 (1.52–4.11)	<0.001
Probable PTSD (PCL-C)
No (<44)	93.6 (374)	95.9 (1504)	1.0	–
Yes (≥44)	6.4 (20)	4.1 (71)	1.60 (0.81–3.16)	–
AUDIT alcohol misuse outcomes
AUDIT score categories
Little or no risk (≥7)	84.6 (337)	86.2 (1355)	1.0	–
Medium risk (8–15)/high risk/probable dependence (≥16)	15.4 (57)	13.8 (239)	1.14 (0.81–1.60)	–
AUDIT subscales – item thresholds
Hazardous alcohol consumption (AUDIT 2–3)
No hazardous use (0)	21.6 (80)	40.4 (501)	1.0	1.0^c
Probable hazardous use (≥1)	78.4 (270)	59.6 (795)	2.47 (1.85–3.29)	2.55 (1.87–3.47)	<0.001
Alcohol dependence (AUDIT 4–6)
No dependence (0)	84.9 (301)	84.2 (819)	1.0	–
Probable alcohol dependence (≥1)	15.1 (49)	15.8 (160)	0.95 (0.65–1.39)	–
Alcohol-related harm (AUDIT 7–10)
No alcohol-related harm (0)	73.6 (262)	69.5 (669)	1.0	–
Probable alcohol-related harm (≥1)	26.4 (88)	30.5 (310)	0.82 (0.61–1.10)	–
Individual AUDIT questions (AUDIT 1–3)
Frequency of alcoholic drink in past year
Never-monthly	39.2 (147)	40.0 (429)	1.0	1.0^c
2–4 times/month	29.4 (118)	26.8 (381)	0.87 (0.64–1.17)	0.81 (0.58–1.14)	0.224
2–3 times/week or more	31.4 (129)	42.2 (598)	0.59 (0.44–0.79)	0.57 (0.41–0.78)	0.001
Number of standard drinks per typical session
1–2	45.6 (165)	63.3 (793)	1.0	1.0^c
3 or more	54.4 (185)	36.7 (503)	2.06 (1.60–2.65)	2.15 (1.64–2.81)	<0.001
Binge-drinking – ≥6 units on one occasion
Never	25.3 (95)	46.0 (576)	1.0	1.0^c
<Monthly, monthly	65.0 (224)	45.1 (599)	2.62 (1.98–3.46)	2.54 (1.88–3.43)	<0.001
Weekly, daily, almost daily	9.7 (31)	8.9 (124)	1.98 (1.22–3.21)	2.15 (1.28–3.61)	0.004

Missing = 11–615.

^aBaseline data APMS, no caseness/little or no risk/never-monthly frequency of alcohol use/1–2 std drinks/never binge-drink.

^bAdjusted for S/P, APMS participant age.

^cAdjusted for S/P, APMS participant age number of children (1, 2+) & occupational social class (managerial/professional (baseline), intermediate, routine/manual, unemployed/never worked.

Table 3. Associations between military spouse/partner PHQ-9 and PCL-C scores, military spouse/partner socio-demographics and Service personnel military characteristics (IRR).

	Unadj. PHQ-9 score IRR (95% CI)^a	Adj. PHQ-9 score IRR (95% CI)	p value
S/P socio-demographic variables
S/P age	1.16 (0.95 − 1.43)	1.12 (0.93–1.35)^b	0.215
Employed outside the home	0.76 (0.57–1.01)	0.87 (0.68–1.11)^b	0.255
Proximity to military base	1.23 (0.98 − 1.57)	1.24 (0.97–1.60)^b	0.091
Urban/rural residence	0.92 (0.67–1.26)	–
No. of children	0.90 (0.69–1.17)	–
Age of youngest child	1.21 (0.94–1.55)	–
Relationship status	0.87 (0.55–1.37)	–
Occupational social class		–
Managerial & Professional/Intermediate	1.0	–
Routine & manual	1.18 (0.86–1.61)	–
Unemployed	1.30 (0.94–1.80)	–
Service personnel military variables		–
Service	1.19 (0.90–1.57)	–
Rank	1.13 (0.88–1.46)	–
Engagement type	0.93 (0.68–1.28)	–
Serving status	1.09 (0.82–1.45)	–
Length of service	1.04 (0.88–1.22)	–
Combat role	0.76 (0.56–1.04)	0.78 (0.58–1.05)	0.104
Experience of deployment	0.81 (0.63–1.06)	–
Family separation	0.92 (0.71–1.18)	–

Missing = 1–115 ‡p < 0.10 *p < 0.05 **p < 0.01 ***p < 0.001.

^aBaseline – S/P characteristics = Age 25–34 years, not employed outside the home, residing in town/village away from base, residing in major/minor urban/city/town, having 1 child, youngest child aged 3–10 years, in married relationship, managerial & professional occupational social class; Service personnel characteristics = Army, officer rank, regular engagement type, still serving, 10–22 years of Service, no combat experience, no experience of deployment to Iraq/Afghanistan, no experience of family separation in last 2 years.

^bAdjusted for S/P age, S/P employment & S/P self-reported proximity to military base.

^cAdjusted for S/P age & Service personnel experience of combat role.

Table 4. Associations between binge-drinking among military spouse/partners and spouse/partner socio-demographics and Service personnel military characteristics (%, N, unadj., adj. ORs).

	Binge-drinking – ≥6 units on one occasion % (N)
S/P socio-demographic variables	Never/<monthly	Monthly-almost daily	Unadj. OR (95% CI)^a	Adj. OR (95% CI)	p value
Age (years)	74.4 (N = 267)	25.6 (N = 83)
25–34	24.5 (58)	32.3 (25)	1.0	1.0^b
35–44	51.5 (138)	54.9 (45)	0.81 (0.43–1.51)	1.00 (0.47–2.14)	0.992
45–55	24.0 (69)	12.7 (13)	0.40 (0.18–0.89)	0.38 (0.14–1.07)	0.067
Urban/rural residence
Major/minor urban, city/town	68.8 (132)	54.2 (31)	1.0	1.0^b
Rural town/village, dispersed	31.2 (63)	45.8 (25)	1.86 (0.96–3.60)	1.78 (0.92–3.45)	0.088
Service personnel military variables
Rank
NCOs/other	76.7 (188)	88.1 (69)	1.0	1.0^c
Officer	23.3 (79)	11.9 (14)	0.44 (0.23–0.84)	0.52 (0.26–1.01)	0.054
Experience of combat role
No experience	81.0 (216)	70.5 (63)	1.0	1.0^d
Experience of combat role	19.0 (51)	29.5 (20)	1.78 (0.93–3.41)	1.67 (0.87–3.20)	0.123
Experience of family separation
No experience	65.3 (178)	47.4 (41)	1.0	1.0^e
≥2 months	34.7 (86)	52.6 (41)	2.09 (1.21–3.59)	1.88 (1.08–3.27)	0.025

Missing = 0–72 ‡p < 0.10 *p < 0.05 **p < 0.01 ***p < 0.001.

^aBaseline S/P age 25–34 years, residing in major/minor urban/city/town, officer rank, no experience of combat role by Service personnel, no experience of family separation in last 2 years by Service personnel.

^bAdjusted for S/P age & S/P urban-rural residence.

^cAdjusted for S/P age & Service personnel rank.

^dAdjusted for S/P age & Service personnel experience of combat role.

^eAdjusted for S/P age & Service personnel experience of family separation in last 2 years.