Primary and secondary benefits from treatment for alcoholism.

The authors recorded diagnoses and total number of sick days for 148 men before and after treatment for alcoholism in a Navy alcoholic rehabilitation center. Over a 4-year period (2 years before and 2 years after treatment), there was a reduction of sick days for each man and a reduction of alcohol-and nonalcohol-related complaints. The authors stress the importance of valid evaluation criteria for alcohol rehabilitation programs.

A demographic analysis of suicide among U.S. Navy personnel.

Age-, sex-, race-, and employment-adjusted standardized mortality ratios (SMRs) were calculated for sailors committing suicide between 1990 and 1996 and compared with adjusted SMRs for civilians. Cluster analyses were conducted on annual rates from 1983 through 1995 to examine differences between comparison groups across time and location. Results showed fewer than expected suicides for Caucasian and African American males and a somewhat higher than expected suicide rate among other ethnic group males and among Caucasian women. The suicide rate showed an increase during the study period, with some evidence toward a clustering effect in time and space.

Suicide in the U.S. Marine Corps, 1990 to 1996.

Epidemiologic studies of suicide in the military have not controlled for the higher suicide rates of the unemployed expected in comparative national populations. This study compared the observed number of suicides among U.S. Marine Corps personnel from 1990 to 1996 with the expected number based on rates for the employed general U.S. population. Standardized mortality ratios were calculated to identify demographic groups with higher or lower than expected numbers of suicides. The scan statistic and the Knox technique were used to evaluate potential suicide cluster patterns. Overall, there were fewer suicides in the Marine Corps (n = 213) than expected (n = 225). Hispanic and other ethnic group males and female Marines had greater than expected numbers. Evidence for suicide clustering in time and space was equivocal.

Psychiatric disorders among United States Marines wounded in action in Vietnam.

Although the posttraumatic stress disorders of Vietnam veterans have been well documented, the psychological and environmental factors that gave rise to these and other psychiatric disorders remain to be clearly identified. The object of this study is to determine if United States Marines who were wounded in action in Vietnam were also at risk for an impatient admission with a psychiatric disorder. We also wish to examine the effect of the practice of returning psychiatric patients to duty upon completion of treatment on the relationship between combat exposure and psychiatric distress. Records of all hospital admissions for active-duty Marines for the period 1965 to 1972 were examined and personnel having a combat-related wound or injury and/or a psychiatric hospitalization were identified. Rates of first hospitalization were calculated and standardized incidence ratios were used to obtain measures of risk. Results indicated that, compared with Marines not wounded in Vietnam, Marines wounded in Vietnam were at significant risk for having a psychiatric hospitalization. Most of the psychiatric first hospitalizations occurred before being wounded in action, however, and psychiatric patients who were treated and then returned to duty had a significantly greater than expected risk of being subsequently wounded. This risk differed with respect to psychiatric diagnosis due to variations in the practice of returning psychiatric patients to duty on the basis of primary diagnosis. Variations in the probability of being returned to duty also accounted for variations in the relative risk of psychiatric first hospitalizations among wounded Marines by diagnostic category. These results cell into question the validity of using ratios of psychiatric casualties to numbers of wounded personnel as measures of the relationship between combat exposure and psychological distress.