A rapid review of literature on first episode psychosis among United States military service members

ABSTRACT

Background

Current literature does not thoroughly examine the development or treatment of first episode psychosis (FEP) among active duty service members.

Methods

We conducted a rapid review on demographics, epidemiology, assessment, and intervention for FEP among service members. The final dataset contained eight peer-reviewed articles published between 2011 and 2021.

Results

Incidence of FEP among service members ranged from 1.4 to 2.3 for schizophrenia and 5.6 to 9.3 for other psychotic disorders per 10,000 person-years. Risk factors for developing psychosis during active duty service included distance of the place of service to home, multiple substance use, birthplace or place of residence in small towns or large cities, psychosocial stress, placement in an Army service branch or motor transport occupation, and more than one visit to mental health providers in the year before diagnosis. Racial minority status, younger age, less education, lower military grade, less time spent in service, and never-married status were also associated with higher risk of FEP.

Conclusion

Enhancing screening procedures before and after military entrance, reducing the impact of psychosocial stress during military initiation, and providing early, multimodal treatment for FEP would likely improve health outcomes for service members and reduce burden on the Military Health System.

KEYWORDS:

• Military
• psychosis
• schizophrenia
• active duty
• mental health

Acknowledgements

We thank Spencer Case, MS for contributions to study ideation, Justin C. Curry, PhD, Trinity R. Dunham, PsyD, and Derek J. Smolenski, PhD for content review, and Kanchana (Bindu) Kuruganti, PMP for administrative assistance.

Disclosure statement

No potential conflict of interest was reported by the author(s).

Data availability statement

The authors confirm that the data supporting the findings of this study are available within the article.

Disclaimer

The views expressed in this manuscript are those of the authors and do not necessarily represent the official policy or position of the Defense Health Agency, Department of Defense, or any other U.S. government agency. This work was prepared under Contract #W81XWH-21-F-0322 with DHA Contracting Office W81XWH and, therefore, is defined as U.S. Government work under Title 17 U.S.C.§101. Per Title 17 U.S.C.§105, copyright protection is not available for any work of the U.S. Government. For more information, please contact [email protected].

Notes

1. In this article, the term “neurotic disorders” refers to any of the following conditions: anxiety, hysteria, panic attacks, phobias, obsessive compulsive disorder, dysthymia, somatization and neurosis, and not otherwise specified mental disorders (Costello, 2012).

Additional information

Funding

No grant funding was used to support the present study