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. 2016 Apr;61(1 Suppl):56S-63S.
doi: 10.1177/0706743716628853.

Disability and Mental Disorders in the Canadian Armed Forces

Murray Weeks  1 , Bryan G Garber  2 , Mark A Zamorski  3
Affiliations

Disability and Mental Disorders in the Canadian Armed Forces

Murray Weeks et al. Can J Psychiatry. 2016 Apr.

Abstract
in English, French

Objectives: The initial goal was to validate the use of a self-report measure of disability in the Canadian Armed Forces (CAF). The main goal was to document the extent of disability in personnel with and without mental disorders.

Methods: Data were obtained from the 2013 Canadian Forces Mental Health Survey; the sample included 6700 Regular Forces personnel. Disability was measured with the 12-item version of the World Health Organization Disability Assessment Schedule (WHODAS-2); established cut points were used to demarcate severe, moderate, minimal, and no disability. The following recent (past-year) and remote (lifetime but not past-year) disorders were assessed with diagnostic interviews: posttraumatic stress disorder, major depressive episode, generalized anxiety disorder, panic disorder, and alcohol use disorder.

Results: The WHODAS-2 showed good internal consistency (α = 0.89) and a 1-factor structure. Most personnel had no disability (59.2%) or minimal disability (30.8%). However, an important minority had moderate or severe disability (8.4% and 1.6%, respectively). Individuals with recent disorders reported greater disability than those without lifetime disorders, although many had minimal or no disability (41.2% and 24.7%, respectively). Disability increased with the number of recent disorders. Relative to those without lifetime disorders, individuals with remote disorders showed slightly greater disability, but most had no disabilty (57.1%) or minimal disability (35.0%).

Conclusions: The 12-item WHODAS-2 is a valid measure of disability in the CAF. Mental disorders may be important drivers of disability in this population, although limited residual disability is seen in individuals with remote disorders.

Objectif:: L’objectif initial était de valider l’utilisation d’un instrument d’auto-évaluation d’invalidité dans les Forces armées canadiennes (FAC). Le but principal était de documenter l’étendue de l’invalidité chez le personnel avec et sans troubles mentaux.

Méthode:: Les données ont été obtenues de l’Enquête sur la santé mentale des Forces armées canadiennes de 2013; l’échantillon comprenait 6 700 membres de la Force régulière. L’invalidité était mesurée par la version en 12 items du WHODAS-2; des points de découpage établis ont servi à démarquer l’invalidité grave, modérée, minimale et nulle. Les troubles suivants récents (l’année précédente) et distants (de durée de vie mais pas l’année précédente) ont été évalués par des entrevues diagnostiques : trouble de stress post-traumatique, épisode de dépression majeure, trouble d’anxiété généralisée, trouble panique, et trouble lié à l’alcool.

Résultats:: Le WHODAS-2 a révélé une bonne cohésion interne (α = 0,89) et une structure unifactorielle. Pour la plupart, le personnel n’avait pas d’invalidité (59,2 %) ou une invalidité minimale (30,8 %). Cependant, une importante minorité avait une invalidité modérée ou grave (8,4 % et 1,6 %, respectivement). Les personnes ayant des troubles récents ont déclaré une plus grande invalidité que ceux n’ayant pas de troubles de durée de vie, même si beaucoup avaient une invalidité minimale ou nulle (41,2 % et 24,7 %, respectivement). L’invalidité augmentait avec le nombre de troubles récents. Relativement à ceux n’ayant pas de troubles de durée de vie, ceux ayant des troubles distants indiquaient une invalidité légèrement plus élevée, mais la plupart n’avait pas d’invalidité (57,1 %) ou une invalidité minimale (35,0 %).

Conclusions:: Le WHODAS-2 en 12 items est une mesure valide de l’invalidité dans les FAC. Les troubles mentaux peuvent être d’importants facteurs d’invalidité dans cette population, bien qu’une invalidité résiduelle limitée s’observe chez ceux ayant des troubles distants.

Keywords: World Health Organization Disability Assessment Schedule; disability; mental disorders; military.

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Conflict of interest statement

Declaration of Conflicting Interests: The author(s) declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article.

Figures

Figure 1.
Figure 1.
Extent of disability in those with and without any mental disorder.
See this image and copyright information in PMC

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