Psychological morbidity, quality of life, and self-rated health in the military personnel

Figures & data

Table 1 Comparison of demographic factors, CHQ scores, and QOL scores by military rank (officer, NCO, enlisted men)

	Officer	NCO	Enlisted men	P-value	Scheffe post hoc
	Number (%) or mean ± SD	Number (%) or mean ± SD	Number (%) or mean ± SD
Sex
Male	146 (91.3)	97 (93.3)	248 (100)	<0.001*	A, C
Female	14 (8.8)	7 (6.7)	0 (0)
Age (years)	30.0±6.2	25.3±3.9	23.7±2.75	<0.001*	A, B, C
Military service
Army	121 (79.6)	48 (46.6)	112 (48.3)	<0.001*	A, B
Air force	7 (4.6)	1 (1.0)	5 (2.2)
Gendarme	24 (15.8)	54 (52.4)	115 (49.6)
Service type
Volunteer	145 (95.4)	50 (49)	13 (5.7)	<0.001*	A, B, C
Mandatory	7 (4.6)	52 (51)	215 (94.3)
Education (years)	15.2±2.9	14.3±3.0	14.1±3.2	0.04*	A
Service years	11.1±7.3	4.8±5.7	1.5±2.4	<0.001*	A, B, C
Smoking history
Yes	54 (34.8)	39 (37.9)	84 (35)	0.858
No	101 (65.2)	64 (62.1)	156 (65)
Alcohol use
Yes	13 (8.2)	13 (13)	25 (10.5)	0.465
No	145 (91.8)	87 (87)	212 (89.5)
VAS
Now	72.5±13.1	67.7±13.6	66.3±14.1	<0.001*	A, B
Before service	74.6±12.6	71.0±16.8	72.0±13.7	0.079
Total CHQ score	9.62±5.61	11.07±5.48	11.51±5.96	0.005*	A
Cut-off point 9
≤9	93 (57.4)	40 (38.5)	106 (42.2)	0.002*	A, B
≥10	69 (42.6)	64 (61.5)	145 (57.8)
QOL score	83.98±12.2	80.64±10.8	79.67±11.1	0.001*
Physical	12.16±1.9	11.46±1.8	11.23±1.8	<0.001*	A, B
Psychological	13.16±1.9	12.98±1.8	12.56±2.1	0.009*	B
Social	13.89±2.3	13.28±2.4	13.09±2.3	0.003*	B
Environmental	12.96±2.3	12.26±2.1	12.23±2.2	0.009*	A, B

Notes: A: Statistically significant comparison of officers and enlisted men. B: Statistically significant comparison of officers and NCOs. C: Statistically significant comparison of NCOs and enlisted men.

* Statistically significant difference.

Abbreviations: CHQ, General Health Questionnaire-12, Chinese version; QOL, quality of life; NCO, noncommissioned officer; SD, standard deviation; VAS, Visual Analog Scale.

Figure 1 Comparison of the WHOQOL-BREF domain scores by rank.

Notes: QOL: physical domain (A); psychological domain (B); environmental domain (C); social domain (D). *P<0.05; **P<0.01.
Abbreviations: QOL, quality of life; WHOQOL-BREF, World Health Organization Quality of Life Instrument, brief version.

Table 2 CHQ item scores: comparison by rank (officer, NCO, enlisted men)

		Officer	NCO	Enlisted men	F	P-value	Scheffe post hoc
		Mean ± SD	Mean ± SD	Mean ± SD
1.	Been suffering from headaches or pressure in your head	1.72±0.90	2.06±0.80	1.93±0.87	5.28	0.005*	A
2.	Had palpitations and worried that you might have heart trouble	1.54±0.72	1.52±0.75	1.61±0.76	0.75	0.472
3.	Had discomfort or a feeling of pressure in your chest	1.50±0.69	1.68±0.85	1.69±0.81	3.25	0.039*
4.	Been suffering from shaking or numbness of your limbs	1.43±0.62	1.59±0.77	1.62±0.80	3.41	0.034*	B
5.	Lost much sleep through worry	2.04±0.93	2.52±0.95	2.48±0.95	13.08	<0.001*	A, B
6.	Been taking things hard	2.04±0.88	2.25±0.79	2.16±0.85	2.16	0.116
7.	Been getting along well with your family or friends	2.38±0.90	2.38±0.83	2.49±0.90	0.99	0.369
8.	Been losing confidence in yourself	1.70±0.78	1.75±0.77	1.83±0.83	1.34	0.260
9.	Been feeling nervous and strung-up all the time	1.61±0.72	1.80±0.79	1.80±0.85	3.08	0.047*
10.	Been feeling hopeful about your future	2.27±0.87	2.73±0.79	2.35±0.88	2.42	0.900
11.	Been worried about your family or close friends	1.85±0.78	1.94±0.79	1.92±0.83	0.53	0.587
12.	Felt that life is entirely hopeless	1.55±0.72	1.45±0.65	1.61±0.83	1.59	0.206

Notes: A: Statistically significant comparison of officers and NCOs; B: Statistically significant comparison of officers and enlisted men.

* Statistically significant difference.

Abbreviations: CHQ, General Health Questionnaire-12, Chinese version; NCO, noncommissioned officer; SD, standard deviation.

Table 3 Comparison of the demographic factors and WHOQOL domain scores by psychological morbidity

	CHQ score ≥10	CHQ score ≤9	β	P-value	Odds ratio	95% CI for experiment B
	Number (%) or mean ± SD	Number (%) or mean ± SD				Lower	Upper
Rank
Officer	69 (42.6)	93 (57.4)	−0.612	0.003*	0.542	0.364	0.809
NCO	64 (61.5)	40 (38.5)	0.157	0.511	1.170	0.733	1.867
Enlisted	145 (57.8)	106 (42.2)
Service
Army	155 (52.2)	142 (47.8)	−0.004	0.983	0.001	0.695	1.429
Air force	39 (66.1)	20 (33.9)	0.576	0.063	3.461	0.970	3.266
Gendarme	103 (52.3)	94 (47.7)
Service type
Volunteer	129 (48.9)	135 (51.1)	−0.389	0.024*	5.090	0.483	0.950
Mandatory	165 (58.5)	117 (41.5)
Sex
Male	378 (56.2)	295 (43.8)	0.322	0.412	1.38	0.639	2.981
Female	13 (48.1)	14 (51.9)
Age	24.86±5.0	25.68±4.8	−0.033	0.035*	0.967	0.938	0.998
Education (years)	13.87±3.5	14.14±3.2	−0.023	0.317	0.977	0.934	1.022
Income (NT, K)	21.3±23.6	22.5±26.4	0.020	0.517	0.420	0.961	1.082
Physical illness	29 (22.8)	98 (77.2)	1.196	<0.001*	27.609	2.117	5.168
Alcohol use	379 (55.6)	303 (44.4)	−0.117	0.059	3.573	0.788	1.004
Smoking	90 (38.5)	144 (61.5)	0.377	0.022*	1.458	1.057	2.011
VAS score (now)	64.09±14.43	73.43±11.11	−0.061	<0.001*	72.023	0.928	0.954
QOL
Physical	11.04±1.87	12.04±1.84	−0.035	0.539	0.377	0.863	1.080
Psychological	12.24±2.05	13.28±1.90	0.013	0.814	0.055	0.907	1.132
Social	12.58±2.42	14.06±2.09	−0.133	0.008*	6.944	0.793	0.967
Environmental	11.62±2.26	13.30±1.97	−0.287	<0.001*	25.905	0.672	0.838

Note:

* Statistically significant difference.

Abbreviations: WHOQOL, World Health Organization Quality of Life Instrument; CHQ, General Health Questionnaire-12, Chinese version; N, number; CI, confidence interval; NCO, noncommissioned officer; NT, New Taiwan dollars; K, thousands; VAS, Visual Analog Scale; QOL, quality of life.

Table 4 Multiple regression analysis of factors for CHQ, QOL, and VAS of health

	Regression coefficient	SE	95% CI for regression coefficient		P-value
			Lower	Upper
Total CHQ score
Constant	14.78	2.37	10.121	19.440	<0.001
Rank	−0.87	0.38	−1.621	−0.111	0.025*
Age	−0.09	0.10	−0.295	0.112	0.376
Sex	−0.51	0.46	−1.422	0.394	0.266
Education	−0.04	0.09	−0.214	0.140	0.678
Service	−0.09	0.07	−0.229	0.047	0.196
Years of service	0.09	0.08	−0.080	0.256	0.303
Income	0.03	0.10	−0.173	0.235	0.767
Physical illness	3.42	0.62	2.199	4.639	<0.001*
Total QOL score
Constant	71.81	4.73	62.52	81.10	<0.001
Rank	1.52	0.76	0.018	3.028	0.045*
Age	0.30	0.20	−0.103	0.708	0.144
Sex	0.55	0.92	−1.260	2.360	0.551
Education	−0.01	0.18	−0.362	0.343	0.958
Service	0.01	0.14	−0.262	0.287	0.930
Years of service	−0.13	0.17	−0.463	0.206	0.451
Income	−0.26	0.21	−0.672	0.143	0.202
Physical illness	−2.39	1.23	−4.824	0.038	0.054
VAS score (now)
Constant	56.71	5.89	45.13	68.29	<0.001
Rank	1.95	0.96	0.071	3.824	0.040*
Age	0.18	0.26	−0.327	0.685	0.487
Sex	1.69	1.15	−0.560	3.953	0.140
Education (years)	0.25	0.22	−0.188	0.691	0.261
Service	−0.19	0.17	−0.538	0.147	0.262
Years of service	−0.03	0.21	−0.450	0.385	0.879
Income	0.15	0.26	−0.358	0.657	0.562
Physical illness	−5.86	1.54	−8.897	−2.836	<0.001*

Notes: R-squared of total CHQ: 0.081; R-squared of QOL: 0.038; R-squared of VAS: 0.076.

* Statistically significant difference.

Abbreviations: CHQ, General Health Questionnaire-12, Chinese version; QOL, quality of life; VAS, Visual Analog Scale; SE, standardized error; CI, confidence interval.

Table 5 Comparison of previous research on psychological morbidity in different military or nonmilitary populations

Authors, publication year	Subjects in the study population	Finding	Case number
Proctor et al, 2001^Citation42	Military (mobilized): US Gulf War-deployed veterans	Gulf War-deployed veterans report lower functional health status	141
Richardson et al, 2008^Citation43	Military (mobilized): Canadian peacekeeping veterans	Veterans with PTSD have significant impairments in mental and physical health-related QOL	125
Forman-Hoffman et al, 2005^Citation44	Military (mobilized): US Gulf War-deployed veterans	Two or more mental disorders associated with impaired health-related QOL	602
Fear et al, 2009^Citation35	Military (mobilized): UK war-fighting veterans	Reported job strain and rank contributed independently to psychological symptoms	4,722
Kehle et al, 2011^Citation45	Military (mobilized): US National Guard soldiers deployed to Iraq	Mental health diagnoses associated with poorer functioning and QOL; PTSD has the strongest relationship with poor social functioning and QOL	348
Marimoutou et al, 2012^Citation46	Military (mobilized): French gendarmes after chikungunya infection: nonhealed, healed patients, and uninfected subjects	All dimensions of the physical and mental components were impaired in chikungunya infection nonhealed subjects	Nonhealed: 37 Healed: 48 Uninfected: 297
Tzeng et al, 2009^Citation41	Military (peace time): Physicians, nurses, other specialists in a military hospital in South Taiwan	Younger, hypnotic drug use, and life events had a higher percentage in the psychological morbidity group, and poor QOL	Physicians: 65 Nurses: 416 Others: 304
Kongsakon et al, 2012^Citation47	Military personnel and their families (peace time): Navy and their spouses, 6 months after the 2006 tsunami	Bodily pain, the only indicator subscale of the QOL that was statistically significantly associated with tsunami exposure	434
Mirkovic et al, 2012^Citation48	Civilian, nonmilitary: Adult residents of northern Kosovska Mitrovica	Mental health problems were associated with older age, poor financial situation, abuse	130
Gu et al, 2009^Citation49	Civilian, nonmilitary: A multilevel cross-sectional study of mental disorder in community settings in Zhejiang Province	The mental disorder was associated with age, marital status, residency, education, occupation, and household income.	14,632

Abbreviations: PTSD, posttraumatic stress disorder; QOL, quality of life.

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