Disorders In Military Personnel Research Articles

Does screening shorten delays to care for post-deployment mental disorders in military personnel? A longitudinal retrospective cohort study

ObjectiveTo determine whether post-deployment screening is associated with a shorter delay to diagnosis and care among individuals identified with a deployment-related mental disorder.DesignRetrospective cohort study.SettingCanadian military population.ParticipantsThe cohort consisted of...

0741 Diagnosing Narcolepsy Type II in the Active Duty Population

Abstract Introduction: Introduction There is a high prevalence of sleep disturbances in U.S. military personnel which can significantly impact continued military service. Narcolepsy is a rare sleep disorder and testing results are often variable, especially when cataplexy is absent. Given the high incidence of confounding sleep disorders in military personnel, including insufficient sleep duration and sleep-disordered breathing, a narcolepsy diagnosis may be even more challenging. As this diagnosis is often incompatible with continued military service, extra attention should be given to confounding diagnoses in military personnel. Methods This is a retrospective study of patients aged 18-65, who were diagnosed with narcolepsy type 1 or type 2 at an outside location and subsequently underwent repeat evaluation at our facility. Polysomnography, actigraphy, and multiple sleep latency test results from the time of the original diagnosis, if available, and repeat evaluation were reviewed. The initial diagnosis was compared to the results of repeat testing and the prevalence of narcolepsy vs. another sleep disorder was assessed. Results Two of twenty-three patients retained a diagnosis of narcolepsy on repeat testing. 10 patients were diagnosed with insufficient sleep syndrome (&lt 7 hours sleep/night), 5 displayed significant circadian misalignment (including irregular sleep/wake periods or delayed sleep phase), and 8 were diagnosed with mild obstructive sleep apnea. 7 of the 8 OSA patients had supine predominate OSA, which may have contributed to not being diagnosed on initial testing. The average total sleep time of the group was 6 hours and 49 minutes, consistent with insufficient sleep duration. Conclusion Narcolepsy type 1 and type 2 are exceedingly rare disorders with diagnostic test results that may be influenced by the presence of other common sleep disorders. In this study, re-evaluation resulted in a changed diagnosis in 91 percent of patients, emphasizing the importance of ruling out these confounding diagnoses. Support

ПСИХОЛОГІЧНИЙ СУПРОВІД ДІЯЛЬНОСТІ ВІЙСЬКОВОСЛУЖБОВЦІВ ПІД ЧАС ВИКОНАННЯ ЗАВДАНЬ У МІЖНАРОДНИХ ОПЕРАЦІЯХ З ПІДТРИМАННЯ МИРУ І БЕЗПЕКИ

Introduction. The article is devoted to the research of the actual problem of psychological support of the activity of military personnel of the Armed Forces of Ukraine in peacekeeping operations. Defining the specific tasks of peacekeeping that are inherent in peacekeeping operations in the 21st century.Purpose. Determining the peculiarities of psychological support for the activities of military personnel during the tasks in peacekeeping operations.Methods. Analysis of the peculiarities of peacekeeping activities of military personnel in peacekeeping operations, comparison and generalization of factors of negative psychological impact, systematization of measures of psychological support.Results. The specific tasks of peacekeeping activities that are inherent in peacekeeping operations in the 21st century are identified. Specific factors of negative psychological influence on the psyche of military personnel of national personnel have been established. The proposals for the organization of psychological support for the activities of military personnel during the execution of tasks in peacekeeping operations as a component of their psychological support are substantiated.Originality. The article focuses on the importance and relevance of autogenous methods of psychological support and self-help. The system of effective methods and techniques of psychological self-help is offered.Conclusion. Specificity of military personnel performing tasks in operations is activity under the influence of a number of negative psychological factors, in particular: threats to life, suddenness, novelty, monotony from excess time, group isolation, increase of pace of action, shortage of activities and combinations of activities at the same time and others. To prevent mental disorders in military personnel during prolonged stay in the conditions of negative psychological impact, we have proposed a set of measures of psychological support for peacekeeping activities, which includes both preventive and psychological assistance and self-help. For military personnel who are members of national personnel in peacekeeping operations, the most relevant are the autogenous methods of psychological support (self-help), namely: methods of static and dynamic self-training, breathing techniques, drafting their own code of honor, overcoming pain and others.

Understanding sleep disorders in military personnel and veterans: speculation is not appropriate.

Understanding sleep disorders in military personnel and veterans: speculation is not appropriate.

Epidemiological patterns of traumatic musculoskeletal injuries and non-traumatic disorders in Japan Self-Defense Forces

BackgroundThe epidemiological patterns of musculoskeletal injuries or disorders in military personnel have not been well documented and a better understanding is required for proper preventative measures and treatment. Here, we investigated musculoskeletal injuries or disorders among members of the Japan Self-Defense Forces.MethodsAll orthopedic patients (n = 22,340) who consulted to Japan Self-Defense Forces Hospitals were investigated for their type of injury or disorder, the injured body part, the mechanism, and the cause of injuries.ResultsThirty-nine percent of the cases were classified as traumatic injuries, and 61% were classified as non-traumatic disorders. Of the traumatic injury patients, the injured body part was the upper extremity in 32%, the trunk in 23%, and the lower extremities in 45% of the cases. The most common injured body location was the knee followed by the hand/finger and ankle. Exercise was the most common cause of injury, followed by traffic accident and military training.Contusions were the most common traumatic injuries, followed by sprains and fractures. Of non-traumatic disorders, the lower extremities were reported as the injured part in 43% of the disorders. Lumbar spine disorders were the most common non-traumatic disorders, followed by tendon and joint disorders.ConclusionsOver one-third of orthopedic cases among members of the Japan Self-Defense Forces are traumatic injuries, with the knee being the body part most commonly injured and exercise being the leading cause of injury.

Relationship between Anxiety and Depression with Musculoskeletal Disorders in Military Personnel

Relationship between Anxiety and Depression with Musculoskeletal Disorders in Military Personnel

Gender differences in sleep disorders in the US military

ObjectivesThe purpose of this study is to compare sleep disorders between male and female military personnel. Comorbid behavioral health disorders and chronic pain were also studied in relation to sleep disorders. DesignWe conducted a retrospective review of military personnel who underwent a sleep medicine evaluation and an in-laboratory attended polysomnography. Initial sleep questionnaires, demographics, polysomnographic variables, and comorbid disorders of interest were reviewed and compared for each sex. SettingAll patients were referred to the Wilford Hall Ambulatory Surgical Center Sleep Disorders Center for evaluation of sleep disturbance. ParticipantsOur cohort consisted of 209 military personnel with 51.7% men. The cohort was relatively young with a mean age of 34.3 years. Men had a significantly higher body mass index at 29.4 vs 27.3 in women. ResultsInsomnia was diagnosed in 72 women and 41 men (P< .001), whereas obstructive sleep apnea (OSA) was diagnosed in 92 men and 50 women (P< .001). Depression and anxiety were more common in women. Women had an average of 1.76 ± 1.36 comorbid conditions compared with 1.08 ± 1.19 in men. In patients diagnosed with both insomnia and OSA, women were more likely to have post-traumatic stress disorder, depression, and anxiety. Neither the Epworth Sleepiness Scale (12.8 ± 4.88) nor the Insomnia Severity Index (16.9 ± 5.33) differed between sexes. ConclusionsGender-related differences in sleep disorders are present in active-duty personnel. Behavioral health disorders were frequent comorbid disorders, and women diagnosed with both insomnia and OSA manifested greater psychiatric comorbidity. The frequent association between sleep and behavioral health disorders in military personnel requires further study.

Residual sleep disturbance in Tunisian military patients with post-traumatic stress disorder

IntroductionSleep disorders such as nightmares and insomnia are among the most frequently reported symptoms in patients with post-traumatic stress disorder (PTSD).ObjectiveTo assess the prevalence of residual sleep disorders in military personnel with PTSD.MethodsA cross-sectional study was conducted and included 25 military consultants meeting the criteria of DSM-5 for PTSD. Sleep disorders were assessed using the insomnia severity index (ISI).ResultsThe mean score of the ISI was 14. Fourteen percent of the participants (n = 21) reported difficulty falling asleep. All patients reported difficulties staying asleep. Nightmares were reported by 48% of the sample (n = 12). All patients were under hydroxyzine at dosages ranging from 25 to 50 mg per day. More than half of the sample (n = 18) was under a combination of benzodiazepine and hydroxyzine. Seventy-one percent of patients (n = 15) considered that their sleep difficulties significantly disrupted their daily lives.ConclusionInsomnia is one of the most frequent and persistent symptoms in PTSD patients. These sleep disorders can impede remission and may be due in part to co-morbid depression.Disclosure of interestThe authors have not supplied their declaration of competing interest.

Evaluation of Upper Airway Disorders in Military Personnel With Postdeployment Dyspnea

Evaluation of Upper Airway Disorders in Military Personnel With Postdeployment Dyspnea

Epidemiology of psychiatric disability without posttraumatic stress disorder among U.S. Army and Marine Corps personnel evaluated for disability discharge

Psychiatric disorders are a common reason for disability discharge from the U.S. military. Research on psychiatric disorders in military personnel evaluated for disability discharge has historically focused on posttraumatic stress disorder (PTSD), yet 40% of service members evaluated for a psychiatric-related disability do not have PTSD. This study's objective was to describe characteristics and correlates of disability in Army and Marine Corps personnel diagnosed with psychiatric disorders other than PTSD. In this cross-sectional study, the chi-square and Wilcoxon–Mann–Whitney tests compared the distribution of demographic, disability and deployment characteristics between those evaluated for non-PTSD psychiatric disability (N = 9125) versus those evaluated for any other non-psychiatric condition (N = 78,072). Multivariate logistic regression examined associations between disability retirement and demographic and disability characteristics. Results show a significantly higher prevalence of disability retirement, deployment, and comorbidity among Army and Marine Corps personnel evaluated for disability discharge related to a non-PTSD psychiatric disorder. Mood disorders, anxiety disorders and dementia were the most commonly evaluated psychiatric disorders. Characteristics associated with increased odds of non-PTSD psychiatric-related disability retirement includes being in the Marine Corps (OR = 1.24), being black (OR = 1.29) or other race (OR = 1.33), having a combat-related condition (OR = 2.50), and older age. Service members evaluated for a non-PTSD psychiatric disability have similar rates of disability retirement as those evaluated for PTSD, suggesting non-PTSD psychiatric disorders cause a severe and highly compensated disability. Additional research is needed describing the epidemiology of specific non-PTSD psychiatric disorders, such as depression, in service members evaluated for disability discharge.

The association between inflammatory markers and psychological disorders in veterans and military personnel: a systematic review protocol

Review question(s)/objective(s) The objective of this systematic literature review is to identify whether there is an association between inflammatory markers and psychological disorders in veterans and military personnel. The primary question to be examined is: Is there an association between increased inflammatory markers and psychological disorders in military personnel or veterans? Inclusion criteria Types of participants This review will consider studies that include currently serving military personnel, as well as individuals who have already left the military (veterans). Military populations of all countries and all ethnicities will be considered. Both females and males will be considered. No age restrictions will be applied. This review will exclude studies that involve participants undergoing basic recruit or military training as this population is not considered to have met the definition of being a currently serving military member, or a military veteran in the sense of having had a period of service, or been deployed and involved in a period of active duty. Phenomena of interest The phenomena of interest in this review are inflammatory markers and psychological disorders. Studies that seek to identify changes in inflammatory markers and the presence or absence of psychological disorders will be considered. Specific inflammatory markers are likely to include C-Reactive Protein, Interleukin-6, and Tumour Necrosis Factors. Psychological disorders of interest will include posttraumatic stress disorder, depression and anxiety related conditions, adjustment disorder as well as somatic complaints; however, studies which have sought to identify other psychological disorders will also be considered. Types of outcomes: TRUNCATED AT 250 WORDS

The association between inflammatory markers and psychological disorders in veterans and military personnel: a systematic review protocol

The association between inflammatory markers and psychological disorders in veterans and military personnel: a systematic review protocol

Lower health related quality of life in U.S. military personnel is associated with service-related disorders and inflammation

Military personnel who have combat exposures are at increased risk for the service-related disorders of post-traumatic stress disorder (PTSD), depression, sleep disturbances and decreased health related quality of life (HRQOL). Those with a traumatic brain injury (TBI) are at even greater risk. Inflammation is associated with these disorders and may underlie the risk for health declines. We evaluated 110 recently deployed, military personnel presenting with sleep disturbances for service-related disorders (TBI, PTSD, and depression) as well as HRQOL. ANOVA models were used to examine differences among military personnel with two or more service-related disorders (high comorbid group), or one or no disorders (low comorbid group). Logistic regression models were used to determine associations among interleukin-6 (IL-6) to HRQOL and service-related disorders. Approximately one-third of the sample had two or more service-related disorders. HRQOL was lower and IL-6 concentrations were higher in military personnel with PTSD or depression, with the most profound differences in those with more service-related disorders, regardless of sleep disorder. Having symptoms of depression and PTSD resulted in a 3.5-fold risk to be in the lower quartile of HRQOL and the highest quartile of IL-6. In a linear regression model, 41% of the relationship between HRQOL and IL-6 concentrations was mediated by PTSD and depression. Military personnel with PTSD and depression are at high risk for lower HRQOL, and higher IL-6 concentrations. Comprehensive treatment is required to address co-occurring service-related disorders in military personnel to promote health and well-being.

Sleep Disorders and Associated Medical Comorbidities in Active Duty Military Personnel

Describe the prevalence of sleep disorders in military personnel referred for polysomnography and identify relationships between demographic characteristics, comorbid diagnoses, and specific sleep disorders. Retrospective cross-sectional study. Military medical treatment facility. Active duty military personnel with diagnostic polysomnogram in 2010. Primary sleep disorder rendered by review of polysomnogram and medical record by a board certified sleep medicine physician. Demographic characteristics and conditions of posttraumatic stress disorder (PTSD), mild traumatic brain injury (mTBI), anxiety, depression, and pain syndromes determined by medical record review. Primary sleep diagnoses (n = 725) included: mild obstructive sleep apnea (OSA), 207 (27.2%); insomnia, 188 (24.7%); moderate-to-severe OSA, 183 (24.0 %); and paradoxical insomnia,39 (5.1%); behaviorally induced insufficient sleep syndrome, 68 (8.9%) and snoring, 40 (5.3%) comprised our control group. Short sleep duration (< 5 h) was reported by 41.8%. Overall 85.2% had deployed, with 58.1% having one or more comorbid diagnoses. Characteristics associated with moderate-to-severe OSA were age (adjusted odds ratio [OR], 1.03 [95% confidence interval {CI}, 1.0-1.05], sex (male) (adjusted OR, 19.97 [95% CI, 2.66-150.05], anxiety (adjusted OR, 0.58 [95% CI, 0.34-0.99]), and body mass index, BMI (adjusted OR 1.19 [95% CI, 1.13-1.25]; for insomnia, characteristics included PTSD (adjusted OR, 2.12 [95% CI, 1.31-3.44]), pain syndromes (adjusted OR, 1.48 [95%CI, 1.01-2.12]), sex (female) (adjusted OR, 0.22 [95% CI, 0.12-0.41]) and lower BMI (adjusted OR, 0.91 [95% CI, 0.87, 0.95]). Service-related illnesses are prevalent in military personnel who undergo polysomnography with significant associations between PTSD, pain syndromes, and insomnia. Despite having sleep disorders, almost half reported short sleep duration. Multidisciplinary assessment and treatment of military personnel with sleep disorders and service-related illnesses are required. Mysliwiec V; McGraw L; Pierce R; Smith P; Trapp B; Roth BJ. Sleep disorders and associated medical comorbidities in active duty military personnel. SLEEP 2013;36(2):167-174.

Correlates of Sexual Risk Behavior in Sexually Active Male Military Personnel Stationed Along Border-Crossing Zones in the Dominican Republic

A survey was conducted of sexually active male military personnel stationed along major border-crossing zones between the Dominican Republic (DR) and Haiti, taking an applied scientific approach, to better inform prevention programming with military personnel in the region. A subsample of 470 sexually active male military personnel was drawn from a stratified systematic sample of military personnel stationed along the three largest border-crossing zones on the western border of the Dominican Republic. Using a verbally administered questionnaire, an examination of how foci of current HIV prevention programming with military personnel correlated with key sexual risk behavioral outcomes was conducted. Mental health factors such as probable alcohol abuse and posttraumatic stress disorder showed consistent associations with sexual risk behaviors. Participants showed a relatively high level of HIV/AIDS-related knowledge, a moderate level of negative attitudes toward condoms, and a moderate level of stigma toward people living with HIV/AIDS. Psychosocial factors, which are typically preventive in nature, were not associated with decreased sexual risk behaviors. Gaps were identified in HIV prevention programming that need to be addressed in this population of sexually active male military personnel. Although knowledge, attitudes, and psychosocial factors are important foci of HIV prevention programming, they were not associated with sexual risk behaviors, particularly after controlling for mental health factors. The authors suggest that prevalent psychiatric disorders in military personnel, such as posttraumatic stress disorder, should be factored in to the development of HIV prevention programs for military personnel.

Unhappy Odysseys. Psychiatric hospitalizations among Vietnam returnees.

IN AN excellent paper on psychiatric disorders in military personnel during World War II, Grinker¹pointed out that the majority of psychiatric admissions among returnees are not men who have returned with war neuroses, but those who develop signs of illness after completing a full term of duty. It was speculated that this may have been due to mild neuroses which were held in check only as long as there was a purpose for so doing. After release from combat this motivation failed. It was also speculated that the return of a weakened individual to a conflictual or distorted home situation might be a precipitating factor, or that there were difficulties of a changed personality attempting to adjust itself to relatively normal circumstances. Major categories observed included passive-dependent reactions, hostile aggressives, depressives, psychosomatic reactions, and psychotic-like states. The largest group, the dependents, seemed