Alcohol misuse and functional impairment in the UK Armed Forces: A population-based study

Abstract 

Aim

To assess whether alcohol misuse was associated with functional impairment in the military, and whether an association between any of the measures of alcohol misuse and impairment would be explained by psychiatric comorbidity.

Design

Large cross-sectional study.

Participants

8585 responders of a random sample of the regular United Kingdom Armed Forces who completed a questionnaire in 2005 were included in the analyses.

Measurements

Five items of the Short Form Questionnaire-36 (SF-36) specifically dealing with functional impairment, and the main independent variable was alcohol misuse based on the Alcohol Use Disorders Identification Test (AUDIT).

Findings

An AUDIT score of ≥20 was consistently associated with impairment with odds ratios between 1.8 (95% confidence interval 1.4–2.3) and 3.7 (2.8–4.8). AUDIT scores <20 did not increase impairment. Those with a hazardous pattern of drinking (AUDIT score 8–15) perceived their functioning to be better than those with an AUDIT score <8. A score indicating alcohol dependence was associated with impairment, as, to a lesser extent, was alcohol related-harm. Binge drinking was not associated with impairment. Half of those with an AUDIT score of ≥20 had psychological comorbidities.

Conclusion

Perception of impairment was mainly related to those with an AUDIT score of ≥20 or more, those who had an indication of alcohol dependence or alcohol related-harm. Intervention on an individual basis should be focused on these groups, while effective public health interventions could be enhanced for everyone.

Keywords: Alcohol dependence, Alcohol related-harm, Functional impairment, Military, Posttraumatic stress disorder, Psychiatric comorbidity, Psychological distress