The application of forward psychiatry among Malaysian soldiers on battlefield: Case Series

Abstract

Introduction: The forward psychiatry practice in the combat field has proven effective in reducing the attrition rates due to combat and operational stress of the service members. The concept has evolved over the years with the same objective to conserve the fighting troops' strength and minimize the incident rates of post-traumatic stress disorder among the soldiers. The Combat and Operational Stress Reaction (COSR) team has been deployed to the conflict zone and applied the forward psychiatry principles to the troops on the battlefield. Case Series: Here, we presented 3 case series of service members that were attended by the COSR team during their deployment on the frontline. First, a serviceman presented with late recognition of acute stress symptoms following active combat duty with poor support from his unit. Second, a combat engineer presented with anxiety and somatic symptoms after combat duty; third, a combat radio operator with early detection of acute stress symptoms by his unit commander. Results: In the first case, the patient's psychological condition deteriorated, requiring frequent sedation and transfer to a military tertiary hospital. In the second and third cases, both patients improved and returned to their duties with individualized psychotherapy and relaxation techniques. Conclusion: Early detection of the symptoms and intervention based on the principles of forward psychiatry in active combat zone facilitate service members' return to function and reduce complications and morbidity to their psychological health. ASEAN Journal of Psychiatry Vol. 23(8) August, 2022; 1-11.