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1.
J Trauma Stress ; 29(2): 149-57, 2016 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-26990003

RESUMO

The primary aim of this study was to evaluate whether being treated for mental health or nonbattle physical injury during military combat deployment was associated with higher risk for postdeployment mental disorders and poorer career outcomes than seen in the general combat-deployed population. Service members treated in theater for mental health (n = 964) or noncombat injury (n = 853) were compared with randomly sampled personnel (n = 7,220) from the general deployed population on diagnosed mental disorders and early separation from service. Deployment, medical, and career information were obtained from Department of Defense archival databases. Over half of the personnel who received mental health treatment while deployed were diagnosed with 1 or more mental disorders postdeployment and/or were separated from service before completing their full-term enlistment. This was significantly higher than expected compared to the general deployed group, adjusting for demographic/military characteristics and mental health history (adjusted odds ratios [ORs] ranging 1.62 to 2.96). Frequencies of problems also were higher in the mental health-treated group than in the group treated for nonbattle physical injuries (significant adjusted ORs ranging 1.65 to 2.58). The documented higher risks for postdeployment adjustment problems suggested that especially those treated in theater by mental health providers might benefit from postdeployment risk-reduction programs.


Assuntos
Distúrbios de Guerra/terapia , Transtornos Mentais/terapia , Saúde Mental , Militares , Psicoterapia/métodos , Adulto , Distúrbios de Guerra/epidemiologia , Bases de Dados Factuais , Feminino , Humanos , Masculino , Transtornos Mentais/epidemiologia , Fatores de Risco , Estados Unidos
2.
Prev Chronic Dis ; 9: E97, 2012.
Artigo em Inglês | MEDLINE | ID: mdl-22575082

RESUMO

The Marine Resiliency Study (MRS) is a prospective study of factors predictive of posttraumatic stress disorder (PTSD) among approximately 2,600 Marines in 4 battalions deployed to Iraq or Afghanistan. We describe the MRS design and predeployment participant characteristics. Starting in 2008, our research team conducted structured clinical interviews on Marine bases and collected data 4 times: at predeployment and at 1 week, 3 months, and 6 months postdeployment. Integrated with these data are medical and career histories from the Career History Archival Medical and Personnel System (CHAMPS) database. The CHAMPS database showed that 7.4% of the Marines enrolled in MRS had at least 1 mental health diagnosis. Of enrolled Marines, approximately half (51.3%) had prior deployments. We found a moderate positive relationship between deployment history and PTSD prevalence in these baseline data.


Assuntos
Militares/psicologia , Resiliência Psicológica , Transtornos de Estresse Pós-Traumáticos/diagnóstico , Campanha Afegã de 2001- , Distúrbios de Guerra/diagnóstico , Distúrbios de Guerra/psicologia , Coleta de Dados , Bases de Dados Factuais , Emoções , Humanos , Entrevistas como Assunto , Guerra do Iraque 2003-2011 , Valor Preditivo dos Testes , Fatores de Risco , Transtornos de Estresse Pós-Traumáticos/psicologia , Inquéritos e Questionários , Ferimentos e Lesões
3.
Mil Med ; 177(4): 380-9, 2012 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-22594127

RESUMO

Military personnel deployed in support of combat operations are at significantly higher risk for mental health problems. However, much of what we know about combat-related mental health comes from postdeployment assessments. This study describes the mental health of 1,336 treatment-seeking deployed U.S. military personnel and interventions recommended by military mental health providers in Iraq from January 2006 to January 2007. Cases were primarily young enlisted men, most of whom were on their first combat deployment. Marines made up the majority of the cases (60%), but there were also large numbers of Army and Navy personnel. The most common psychiatric diagnoses were anxiety disorders (31%, including 11% with posttraumatic stress disorder), followed by adjustment (27%) and mood disorders (25%, including 22% with depression). Medication was the most commonly prescribed treatment for patients with psychiatric diagnoses but was often combined with recommendations for psychotherapy/counseling and/or behavioral modifications. The findings illustrate the distribution of mental health conditions seen among treatment-seeking troops while actively serving in a combat environment and the interventions recommended for them. Further examination of postdeployment health outcomes may help to facilitate the development of more effective acute intervention strategies in theater.


Assuntos
Transtornos Mentais/diagnóstico , Transtornos Mentais/epidemiologia , Militares/psicologia , Militares/estatística & dados numéricos , Transtornos de Adaptação/diagnóstico , Transtornos de Adaptação/epidemiologia , Adolescente , Adulto , Transtornos de Ansiedade/diagnóstico , Transtornos de Ansiedade/epidemiologia , Depressão/diagnóstico , Depressão/epidemiologia , Feminino , Humanos , Iraque , Masculino , Transtornos Mentais/terapia , Medicina Militar , Transtornos do Humor/diagnóstico , Transtornos do Humor/epidemiologia , Prevalência , Estudos Retrospectivos , Transtornos de Estresse Traumático/diagnóstico , Transtornos de Estresse Traumático/epidemiologia , Estados Unidos/epidemiologia , Guerra
4.
Mil Med ; 176(11): 1243-52, 2011 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-22165651

RESUMO

Research has documented higher risks for mental health problems among service members deployed to war zones, yet a research limitation has been that assessment has generally occurred often years after combat exposure. The Operational Stress Control and Readiness program integrated mental health practitioners with 1st Marine Division units serving in Iraq. This team documented mental health visits between January 2006 and January 2007 and developed the Theater Mental Health Encounter Database (TMHED). This report describes the TMHED study design, measures, and cases. Of 1336 patients (3180 patient visits), 10% were women, 75% were high school educated, 55% were mid-paygrade enlisted, and 63% were on their first combat deployment. Compared with the overall deployed population, patient percentages included higher percentages of Marines and Navy personnel but lower percentages of Army and Air Force personnel, more junior enlisted but fewer officers, and fewer college graduates. TMHED provides an unprecedented opportunity to study early psychiatric intervention in a combat zone and prospectively examines postdeployment health and career outcomes.


Assuntos
Documentação/métodos , Guerra do Iraque 2003-2011 , Prontuários Médicos , Militares/psicologia , Psiquiatria Militar/organização & administração , Feminino , Humanos , Masculino , Serviços de Saúde Mental/organização & administração , Projetos de Pesquisa
5.
Mil Med ; 176(3): 253-60, 2011 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-21456349

RESUMO

Mental health treatment of military service members places unique demands on providers as their patients experience combat stress. This study assessed levels and predictors of burnout among mental health providers (N = 97) at military facilities, using a self-administered survey of demographic and work-related measures and the Maslach Burnout Inventory. Burnout levels were comparable to studies of civilian mental health providers but were less severe than those of the Maslach Burnout Inventory normative sample. Working more hours, having more patients with personality disorders, increased patient caseloads, female gender, and being a psychiatrist were predictive of higher burnout scores. Having more confidants at work, a greater percentage of patients with traumatic brain injury, more clinical experience, and being a psychologist predicted lower burnout scores. These findings suggest that burnout levels among military providers are similar to those among civilian providers and may be alleviated by interventions targeting general institutional risk factors.


Assuntos
Esgotamento Profissional , Transtornos Mentais/terapia , Militares/psicologia , Psiquiatria Militar , Adulto , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Apoio Social
6.
Psychiatr Serv ; 62(1): 15-21, 2011 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-21209294

RESUMO

OBJECTIVE: This purpose of this study was to determine the incidence and types of preexisting mental disorders among military personnel who received mental health services in an Iraqi war zone. METHODS: The study examined psychiatric histories of 1,078 American military personnel (Marines, 65%; Army, 23%; Navy, 11%; and Air Force, <1%) deployed to Iraq and seen by in-theater mental health providers between January 2006 and February 2007. RESULTS: Among the 1,078 patients, the most frequent in-theater diagnoses were anxiety (24%), adjustment (23%), and mood (19%) disorders. Twenty-nine percent of the sample (N=308) had a psychiatric diagnosis in their medical records before their first encounter with mental health services in Iraq (Navy patients, 42%; Army patients, 39%; and Marine Corps patients, 23%). The mean time between last predeployment diagnosis and first in-theater mental health encounter was 21 months. For patients with a prior diagnosis, the highest rate of relapse (receipt of the same diagnosis in theater) was for attention-deficit hyperactivity disorder (57%), followed by anxiety disorders (44%)--especially posttraumatic stress disorder (PTSD) (55%)--mood disorders (38%), and adjustment disorders (32%). CONCLUSIONS: A significant proportion of military personnel who experienced mental health problems in a combat zone had preexisting psychiatric conditions. Because more than half of predeployment diagnoses were received in the nine months before the in-theater mental health encounter, further study may be advisable to determine whether a time-based algorithm for deployability is needed, particularly for PTSD, for which a high rate of repeat diagnosis in theater was found.


Assuntos
Transtornos Mentais/epidemiologia , Militares/psicologia , Adulto , Comorbidade , Feminino , Humanos , Incidência , Guerra do Iraque 2003-2011 , Masculino , Recidiva , Transtornos de Estresse Pós-Traumáticos/epidemiologia , Estados Unidos/epidemiologia
7.
Mil Med ; 171(12): 1239-42, 2006 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-17256692

RESUMO

It is a popularly held belief that psychiatric behavior worsens during a full moon. Research in this area has yielded mixed results. Records from Naval Medical Center San Diego for 1993-2001 were examined to see whether there were higher rates of psychiatric admission associated with particular phases of the moon. Records from 8,473 admissions revealed that there were no more admission on days with a full moon, a new moon, any quarter of the moon, a waxing moon, or a waning moon. This held true for psychiatric patients as a whole, as well as for individuals with particular diagnoses, such as those with a mood disorder or psychotic disorder. Records from 1,909 emergency psychiatric evaluations that occurred between 2002 and 2003 were also examined to see whether a higher percentage of patients might present, but not require hospitalization, during a particular phase of the moon. Once again, no significant effect was found. In summary, lunar phase was not associated in any significant way with psychiatric admissions or emergency presentation.


Assuntos
Serviço Hospitalar de Emergência/estatística & dados numéricos , Serviços de Emergência Psiquiátrica/estatística & dados numéricos , Transtornos Mentais/epidemiologia , Militares/psicologia , Lua , Admissão do Paciente/estatística & dados numéricos , Periodicidade , California/epidemiologia , Folclore , Humanos , Transtornos Mentais/diagnóstico , Militares/estatística & dados numéricos , Psiquiatria Militar , Projetos Piloto , Fatores de Tempo
9.
Mil Med ; 170(3): 219-22, 2005 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-15828698

RESUMO

Admission data from 6366 patients on the psychiatry service at Naval Medical Center San Diego were used to form a linear regression model to examine variables that might influence length of stay. Information was available on active duty status, primary diagnosis, age, gender, and marital status. Active duty service, older age, single marital status, and a primary diagnosis of a psychotic or mood disorder were all significantly associated with longer hospital stays. Primary diagnosis of an adjustment or personality disorder was associated with a shorter stay. Taking into account these variables, lengths of stay for active duty personnel averaged 4.00 +/- 0.39 days longer than for equivalent civilian admissions. Although military personnel are generally thought of as a healthy population, psychiatric hospital stays were found to be longer in service members than in their civilian counterparts. Financial repercussions and possible reasons for this are discussed.


Assuntos
Hospitais Militares/estatística & dados numéricos , Tempo de Internação/estatística & dados numéricos , Psiquiatria Militar/estatística & dados numéricos , Unidade Hospitalar de Psiquiatria/estatística & dados numéricos , Adolescente , Adulto , Idoso , California , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Militares/psicologia , Análise de Regressão , Estados Unidos , Revisão da Utilização de Recursos de Saúde
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