Symptoms In Soldiers Research Articles

Conservative Interventions for Non-Specific Low Back Pain in Tactical Populations: A Systematic Review of Randomized Controlled Trials

Limited evidence exists about non-specific low back pain (NSLBP) interventions among tactical personnel (police officers, firefighters, or army forces). The aim was to identify and systematically review the findings of randomized control trials (RCTs) investigating conservative interventions for the treatment NSLBP in tactical personnel. A search of seven databases for randomized controlled trials RCTs were conducted. Two independent reviewers extracted data and assessed the risk of bias (PEDro scale). Five RCTs (n = 387 military subjects; median PEDro score = 7/10) were included. The trials were highly heterogeneous, differing in pain and disability outcome measures, duration of NSLBP symptoms (acute, nonacute, nonchronic, and chronic), types of intervention (exercise, manual therapy, and physical therapy), types of control groups, and intervention durations (4–12 weeks). Two studies reported that strengthening exercise interventions were not effective for reducing pain or disability in military personnel with chronic or nonacute NSLBP. Manual therapy treatment was more effective than usual activities in current pain and pain typical symptoms in soldiers with acute NSLBP after four weeks. A multidimensional intervention reduced disability in military personnel with non-chronic NSLBP after four weeks. Strong evidence does not exist for the efficacy of any conservative interventions in the reduction of pain and disability in tactical populations with NSLBP.

Sleep quality problems three decades post-disaster

Study objectives: Sleep quality problems are a core feature of posttraumatic stress disorder (PTSD). The aims of this study were to describe and evaluate possible differences regarding sleep quality problems and hyperarousal symptoms between exposed and unexposed survivors after an avalanche. Further, we wanted to describe any association between avalanche exposure and survivors’ self-reported sleep quality problems and posttraumatic stress (disorder) symptoms with and without hyperarousal symptoms.Method: The participants were soldiers who had survived an avalanche (n = 12) and a sample of unexposed soldiers (n = 9). Subjective sleep quality problems and posttraumatic stress (disorder) symptoms were assessed using well-validated measures: Pittsburgh Sleep Quality Index (PSQI), Posttraumatic Symptom Scale-10 (PTSS-10), and Impact of Event Scale-15 (IES-15). Hyperarousal symptoms were assessed using a 3-item hyperarousal-index from PTSS-10 (PTSS-10/Hyp index).Results: No significant difference in sleep quality problems was revealed between the exposed and unexposed groups. There was a significant association between those with PTSS-10 ≥ 4 combined with hyperarousal symptoms and sleep quality problems (p = .046), 30 years after the avalanche. Likewise, no significant associations was revaled between those with sleep quality problems and IES-15 ≥ 26 with and without hyperarousal. Binary logistic regression showed that those with sleep quality problems (PSQI > 5) 30 years post-disaster, had 2.5 times greater odds (OR = 2.49, 95%CI [0.95–6.55], p = .064) of having hyperarousal symptoms during the whole follow-up period compared to those without sleep quality problems.Conclusion: Our findings may indicate an association between sleep quality problems (PSQI > 5) and hyperarousal symptoms in soldiers with scores above cut-off point for posttraumatic stress (disorder) symptoms.

The Impact of War on Emergence of Depression and Posttraumatic Stress Disorder on Iranian Veterans of Iran-Iraq War

Iran has been involved in many wars throughout its ancient history, a vivid example is the Iran-Iraq war. This imposed war was ongoing during September 1980 – August 1988 (Mohsenian, 2008). ).The main goal of this study was to investigate differences depression and PTSD symptoms in veterans who participated in the Iran-Iraq compared to community sample. The objectives of this research were: 1.Comparing depression in soldiers who are PTSD patients and ordinary people. 2. Comparing PTSD symptoms in soldiers and ordinary people. The research hypotheses were formulated according to the defined objectives. The statistical population included the Iran-Iraq war veterans and the ordinary male individuals within the age range of 25-50 residing in Tehran. . The data analysis for present research was down descriptively. The Foundation of Martyrs and Veterans’ Affairs of the city of Tehran permitted the researcher to select the statistical samples through the families of martyrs and veterans in person. The related questionnaires were handed in to the testees in person. The research objectives and nondisclosure of information were explained to the testees prior to distribution of the questionnaire. The data was collected using a PTSD checklist by Weathers, Litz, Herman, Huska, Kean etal (1993) and the Beck depression inventory. The multivariate effect indicates a significant difference between the depression and PTSD in war veterans and ordinary individuals aged 25-50. Depression and PTSD in Iran-Iraq war veterans it was higher compared to ordinary individuals.

Military small arms fire in association with acute decrements in lung function

ObjectiveAfter introduction of unleaded ammunition, Norwegian Armed Forces received reports of acute respiratory symptoms in soldiers after exposure to fumes from firing the standard weapon, HK416. The aim of the...

The class-dimensional structure of PTSD before and after deployment to Iraq: Evidence from direct comparison of dimensional, categorical, and hybrid models

The assumption of specific etiology in posttraumatic stress disorder (PTSD) differentiates the disorder from most other psychiatric conditions. A ‘risky test’ of the assumption of specific etiology and resultant trauma-related symptom dimensions was conducted through structural modeling of PTSD symptoms in soldiers before (N=522) and after (n=423) a combat deployment to Iraq. If PTSD represents a discrete diagnostic entity that emerges after trauma exposure, we hypothesized either the number of latent classes should increase from pre- to post-deployment or symptom dimensions should qualitatively distinguish affected from unaffected classes following trauma exposure. Comparison of latent structural models revealed best fitting hybrid models for PTSD and depression with strong invariance of symptom dimensions across classes both before and after deployment and only quantitative (i.e., severity) differences between classes. These findings suggest PTSD is generally well-conceptualized as a dimensional syndrome worsened but not necessarily elicited by trauma exposure.

5-HTTLPR genotype potentiates the effects of war zone stressors on the emergence of PTSD, depressive and anxiety symptoms in soldiers deployed to iraq.

Exposure to war zone stressors is common, yet only a minority of soldiers experience clinically meaningful disturbance in psychological function. Identification of biomarkers that predict vulnerability to war zone stressors is critical for developing more effective treatment and prevention strategies not only in soldiers but also in civilians who are exposed to trauma. We investigated the role of the serotonin transporter linked polymorphic region (5-HTTLPR) genotype in predicting the emergence of post-traumatic stress disorder (PTSD), depressive and anxiety symptoms as a function of war zone stressors. A prospective cohort of 133 U.S. Army soldiers with no prior history of deployment to a war zone, who were scheduled to deploy to Iraq, was recruited. Multilevel regression models were used to investigate associations between 5-HTTLPR genotype, level of war zone stressors, and reported symptoms of PTSD, depression and anxiety while deployed to Iraq. Level of war zone stressors was associated with symptoms of PTSD, depression and anxiety. Consistent with its effects on stress responsiveness, 5-HTTLPR genotype moderated the relationship between level of war zone stressors and symptoms of emotional disturbance. Specifically, soldiers carrying one or two low functioning alleles (S or LG ) reported heightened symptoms of PTSD, depression and anxiety in response to increased levels of exposure to war zone stressors, relative to soldiers homozygous for the high functioning allele (LA ). These data suggest that 5-HTTLPR genotype moderates individual sensitivity to war zone stressors and the expression of emotional disturbance including PTSD symptoms. Replication of this association along with identification of other genetic moderators of risk can inform the development of biomarkers that can predict relative resilience vs. vulnerability to stress.

Personal values in soldiers after military deployment: associations with mental health and resilience

BackgroundAfter military deployment, soldiers are at an increased risk of developing posttraumatic psychiatric disorders. The correlation of personal values with symptoms, however, has not yet been examined within a military context.MethodSchwartz’s Portrait Values Questionnaire (PVQ), the Posttraumatic Stress Diagnostic Scale (PDS), and the 11-item version of the Resilience Scale (RS-11) were completed by 117 soldiers of the German Armed Forces who had recently been deployed to Afghanistan (n=40 undergoing initial psychiatric treatment, n=77 untreated).ResultsLogistic regression showed that the value types of hedonism (−), power (−), tradition (+), and universalism (+) were significantly correlated with the probability and severity of PTSD and whether the participant was in treatment or not. The effects were partially mediated by the RS-11 scale values.ConclusionsValue types seem to be associated with psychiatric symptoms in soldiers after deployment. These results could contribute to the further development of therapeutic approaches.

Attention to Threats and Combat-Related Posttraumatic Stress Symptoms

Combat places soldiers at risk for posttraumatic stress disorder (PTSD). The excessive rates of PTSD and other adjustment disorders in soldiers returning home make it imperative to identify risk and resilience factors that could be targeted by novel therapeutic treatments. To investigate the interplay among attention to threat, combat exposure, and other risk factors for PTSD symptoms in soldiers deployed to combat. Longitudinal prospective study of Israeli Defense Force infantry soldiers carried out in 2008 through 2010. Repeated measurements during a 1-year period included baseline and predeployment data collected in training camps and deployment data collected in the combat theater. Infantry soldiers (1085 men; mean age, 18.8 years). Postcombat PTSD symptoms. RESULTS Soldiers developed threat vigilance during combat deployment, particularly when they were exposed to high-intensity combat, as indicated by faster response times to targets appearing at the location of threat relative to neutral stimuli (P < .001). Threat-related attention bias also interacted with combat exposure to predict risk for PTSD (P < .05). Bias toward threat at recruitment (P < .001) and bias away from threat just before deployment (P < .05) predicted postcombat PTSD symptoms. Moreover, these threat-related attention associations with PTSD were moderated by genetic and environmental factors, including serotonin transporter (5-HTTLPR) genotype. Combat exposure interacts with threat-related attention to place soldiers at risk for PTSD, and interactions with other risk factors account for considerable variance in PTSD vulnerability. Understanding these associations informs research on novel attention bias modification techniques and prevention of PTSD.

Combat‐training increases intestinal permeability, immune activation and gastrointestinal symptoms in soldiers

Gastrointestinal (GI) symptoms are common in soldiers in combat or high-pressure operational situations and often lead to compromised performance. Underlying mechanisms are unclear, but neuroendocrine dysregulation, immune activation and increased intestinal permeability may be involved in stress-related GI dysfunction. To study the effects of prolonged, intense, mixed psychological and physical stress on intestinal permeability, systemic inflammatory and stress markers in soldiers during high-intensity combat-training. In 37 male army medical rapid response troops, GI symptoms, stress markers, segmental intestinal permeability using the 4-sugar test (sucrose, lactulose, mannitol and sucralose) and immune activation were assessed during the 4th week of an intense combat-training and a rest period. Combat-training elicited higher stress, anxiety and depression scores (all P < 0.01) as well as greater incidence and severity of GI symptoms [irritable bowel syndrome symptom severity score (IBS-SSS), P < 0.05] compared with rest. The IBS-SSS correlated with depression (r = 0.41, P < 0.01) and stress (r = 0.40, P < 0.01) ratings. Serum levels of cortisol, interleukin-6, and tumour necrosis factor-α, and segmental GI permeability increased during combat-training compared with rest (all P < 0.05). The lactulose:mannitol ratio was higher in soldiers with GI symptoms (IBS-SSS ≥75) during combat-training than those without (IBS-SSS <75) (P < 0.05). Prolonged combat-training not only induces the expected increases in stress, anxiety and depression, but also GI symptoms, pro-inflammatory immune activation and increased intestinal permeability. Identification of subgroups of individuals at high-risk of GI compromise and of long-term deleterious effects of operational stress as well as the development of protective measures will be the focus of future studies.

Sa1446 The Relationships Between Stress, Segmental Intestinal Permeability Changes and GI Symptoms in Soldiers During Combat Training

Introduction and aims Chronic stress in animals is known to have multiple effects on GI physiology, including increased intestinal permeability (IP), altered motility and sensation. Combat training in soldiers as a real-life chronic, mixed psychological and physical stress induced increased IP and pro-inflammatory mediators, as well as GI symptoms (1). In this study we investigated the association between specific GI symptoms, segmental IP changes and stress markers in soldiers during combat training. Methods The following investigations were performed in 37 healthy male soldiers without any pre-existing GI symptoms in the 4th week of intense combat exercises and a subsequent rest period 12 days post-training: 4-sugar segmental IP test using sucrose (gastroduodenal), mannitol (M), lactulose (L) (mainly small bowel) and sucralose (whole gut) (2), serum cortisol and CRF levels, GI symptoms assessed by IBS-SSS, and stress ratings by PSS-10. Means ± SE are shown. Results Of the previously asymptomatic soldiers, 26 (70%) developed GI symptoms during combat training. Specific symptoms were abnormal bowel habits (n=13, 35%) (8 constipation, 5 alternating constipation/diarrhoea), abdominal pain/significant discomfort (n=5, 13%), or both abdominal pain/significant discomfort and abnormal bowel habits (n=8, 22%), and 14 (38%) had an IBS-SSS >75. At resting, 11 (30%) still had GI symptoms. Urinary sucrose excretion 05h was greater during combat training than at rest (1.05±0.18% vs. 0.41±0.05% of oral dose, p<0.01), soldiers with abdominal pain/discomfort had greater sucrose excretion during training than those with changed bowel habits (2.28%±0.82% vs. 0.59%±0.08%, p<0.01) and they also had increased CRF (2.90±0.64 vs. 1.97±0.14pmol/L, p=0.05). Urinary lactulose and mannitol excretion and L/M were similar across symptom groups during combat training and at rest. 0-24h urinary sucralose excretion was higher during training than at rest (1.97%±0.09% vs. 0.66%±0.07%, p<0.01) and in soldiers with changed bowel habits during training compared to those without (2.12%±0.12% vs. 1.73%±0.13%, p<0.05) and they also showed higher cortisol levels (600.15±21.33 vs. 523.75±21.87nmol/L, p<0.05). Conclusions Chronic combat training stress resulted in GI symptoms and altered IP in previously asymptomatic healthy soldiers. Different symptom clusters are associated with distinct underlying changes in GI physiology. Increased upper GI permeability during stress was strongly linked to abdominal pain, possibly relating to altered sensory function. Elevated lower GI permeability was associated with altered GI motility. Clearer identification of predisposing factors for these GI changes will be helpful in pre-empting GI symptoms and the related considerable manpower loss in combat personnel. 1. Li X et al, Gastro May 2011 2. Farhadi, A et al, Life Sci 2006

The Relationship of Early Pain Scores and Posttraumatic Stress Disorder in Burned Soldiers

Early acute pain after injury has been linked to long-term patient outcomes, including the development of posttraumatic stress disorder (PTSD). Several studies have identified a negative correlation between early anesthetic/analgesic usage and subsequent development of PTSD. This retrospective study examined the relationship between early acute pain and severity of PTSD symptoms in soldiers with burn injuries. Of the soldiers injured in Overseas Contingency Operations who had pain scores recorded at admission to the Emergency Department, 113 had burn injuries. Of those transferred to the military burn center, 47 were screened for PTSD using the PTSD checklist-military (PCL-M) survey at least 1 month after injury. Soldiers with mild, moderate, and severe pain scores had similar Injury Severity Scores and TBSA burned (P = .339 and .570, respectively). However, there were significant differences in PCL-M scores between the mild and severe pain groups (P = .017). The pain levels positively correlated with the PCL-M score (rho = 0.41, P = .004) but not with injury severity markers (Injury Severity Score and TBSA). These data suggest that early acute pain may be related to increased PCL-M score and PTSD symptoms. The intensity of pain was not related to the injury severity, and these data also show no association between pain intensity and physiological measures, including blood pressure and heart rate. However, this is a small sample size, and many other factors likely influence PTSD development. Further study is necessary to explore the relationship between early acute pain and subsequent development of PTSD symptoms.

Comparison of Pain and Emotional Symptoms in Soldiers with Polytrauma: Unique Aspects of Blast Exposure

To compare the physical and emotional presentation and pain treatment outcomes of service members who sustained polytrauma secondary to blast with those of soldiers injured by other means. Retrospective medical record review. One of four Veterans Affairs multidisciplinary inpatient Polytrauma Rehabilitation Centers. One hundred twenty-eight Operation Enduring Freedom and Operation Iraqi Freedom military personnel with serious polytrauma injuries and concomitant pain categorized into three groups based on type of injuries: blast injuries, combat injuries other than blast, and noncombat, nonblast injuries. Intensive, interdisciplinary inpatient rehabilitation and pain treatment. Pain intensity ratings; Functional Independence Measure scores; Rancho Los Amigos levels; and opioid analgesic doses. Service members injured via blast demonstrated a broader spectrum of physical injuries, higher levels of admission and discharge opioid analgesic use, reduced improvement in pain intensity following treatment, and much higher rates of posttraumatic stress disorder and other psychiatric diagnoses than those injured via other means. Blast injury may be associated with differential physical, emotional, and pain-related symptoms that pose increased challenges for successful treatment.

Psychological resilience and postdeployment social support protect against traumatic stress and depressive symptoms in soldiers returning from Operations Enduring Freedom and Iraqi Freedom

A number of studies have examined the prevalence and correlates of posttraumatic stress disorder (PTSD), depression, and related psychiatric conditions in soldiers returning from Operations Enduring Freedom and Iraqi Freedom (OEF/OIF), but none have examined whether factors such as psychological resilience and social support may protect against these conditions in this population. A total of 272 predominantly older reserve/National Guard OEF/OIF veterans completed a mail survey assessing traumatic stress and depressive symptoms, resilience, and social support. Resilience scores in the full sample were comparable to those observed in civilian outpatient primary-care patients. Respondents with PTSD, however, scored significantly lower on this measure and on measures of unit support and postdeployment social support. A hierarchical regression analysis in the full sample suggested that resilience (specifically, increased personal control and positive acceptance of change) and postdeployment social support were negatively associated with traumatic stress and depressive symptoms, even after adjusting for demographic characteristics and combat exposure. These results suggest that interventions to bolster psychological resilience and postdeployment social support may help reduce the severity of traumatic stress and depressive symptoms in OEF/OIF veterans.

Editorial Comment on "Psychological Resilience and Postdeployment Social Support Protect Against Traumatic Stress and Depressive Symptoms in Soldiers Returning from Operations Enduring Freedom and Iraqi Freedom"

79 Pietrzak et al. (2009a) used a cross-sectional methodological approach to support the premise that increased resilience and adequate social support protect against the potentially deleterious effects of traumatic stress. The emerging concern about behavioral health in servicemembers serving in Operations Enduring Freedom and Iraqi Freedom (OEF/OIF) has prompted a wave of research that is now almost a 10 years in the making. Several studies introduced in the literature during that time examined post-traumatic stress disorder (PTSD), depression, and related psychopathological problems. However, prior to the Pietrzak et al. (2009a) study, no known research in OEF/OIF veterans examined variables that may confer protection against traumatic stress and depressive symptoms. Their study demonstrated that two key variables which appear to confer protection are psychological resilience and perceived social support. Pietrzak et al. (2009a) hypothesized that OEF/OIF veterans with PTSD would score lower on measures of resilience and social support than veterans without PTSD. Their hypothesis also stated that increased resilience and social support would be negatively associated with severity of traumatic stress and depressive symptoms. They used the Post-traumatic Stress Disorder Checklist – Military Version (PCL-M) to measure PTSD and the Connor-Davidson Resilience Scale (CD-RISC) to measure psychological resilience in a battery of self-report assessments that also examined combat experiences, depressive symptoms, unit support, and post-deployment social support. The researchers established a cut-off score on the PCL-M to identify veterans with PTSD. Among the 272 Active and Reserve component veterans from all services who participated in the study as volunteer respondents from the state of Connecticut, those in the PTSD group scored lower on the CD-RISC (less resilience) than those in the no-PTSD group. In addition, regression analysis techniques suggested that scores measuring psychological resilience on the CD-RISC and post deployment social support were negatively associated with PTSD and depressive symptoms. The authors of the study adequately addressed the limitations in their study, one of which involved the crosssectional nature of the study. The cross-sectional study provided a “snap-shot” in time on the behavioral health of OEF/OIF veterans. They addressed this limitation by emphasizing the need for longitudinal studies that examine the role of resilience and support factors over time. Pietrzak et al., (2009a) convincingly conclude that resilience and social support may be protective against traumatic stress and depressive symptoms by a host of mechanisms. Those mechanisms include: decreased hypothalamic-pituitary-adrenal axis reactivity, decreased stress related physiological arousal, decreased fear-related appraisals and cognitions, improved emotional regulation, and enhanced self-efficacy and control. Several of those mechanisms shed light on the importance of adopting a biopsychosocial perspective in the consideration of future research and applications. Editorial Comment on “Psychological Resilience and Postdeployment Social Support Protect Against Traumatic Stress and Depressive Symptoms in Soldiers Returning from Operations Enduring Freedom and Iraqi Freedom” Depression and Anxiety (Pietrzak et al., 2009a). LTC Craig A. Myatt, PhD; Douglas C. Johnson, PhD

Psychological symptoms and marital satisfaction in spouses of Operation Iraqi Freedom veterans: Relationships with spouses' perceptions of veterans' experiences and symptoms.

Much research has shown that spouses of combat veterans with posttraumatic stress disorder (PTSD) have higher rates of psychological and marital distress than do spouses of veterans without PTSD; however, very few studies have examined potential mechanisms of this increased vulnerability. The current study examined spouses of National Guard soldiers recently returned from deployments in Iraq. In addition to documenting elevated levels of psychological symptoms in these spouses, the authors found that spouses experienced greater symptom severity when they perceived high levels of symptoms in soldiers but the soldiers endorsed low levels of symptoms. Furthermore, spouses' marital satisfaction was negatively linked to soldiers' self-reported symptom severity only when spouses perceived that soldiers had experienced low levels of combat activity while deployed. When spouses perceived high levels of such activity, soldiers' self-reported symptoms had no relationship with spouses' marital satisfaction. These findings highlight the importance of interpersonal perceptions in intimate relationships and are consistent with the notion that uncontrollable attributions for a relative's mental health problems may provide a buffer against relationship distress. (PsycINFO Database Record (c) 2008 APA, all rights reserved).

Posttraumatic stress and depression symptoms in soldiers returning from combat operations in Iraq and Afghanistan

The purpose of the present research was to identify rates of posttraumatic stress and depressive symptoms in soldiers returning from war. During reintegration training, U.S. Army soldiers, who recently returned from a 12-month deployment to either Iraq (Operation Iraqi Freedom, n = 2,275) or Afghanistan (Operation Enduring Freedom, n = 1,814), completed study materials. Surveys assessed self-reported levels of depression, posttraumatic stress, and life satisfaction. Results indicated that approximately 44% of soldiers who volunteered to participate self-reported clinically significant levels of depressive symptoms, posttraumatic stress symptoms, or both. Although assessing symptoms and not disorders, these results suggest a potentially high rate of mental health concerns in soldiers immediately after returning from a combat zone. Further research should examine the utility of broad scale interventions.

Multiple Physical Illnesses Common In Iraq War Veterans With PTSD

Back to table of contents Previous article Next article Professional NewsFull AccessMultiple Physical Illnesses Common In Iraq War Veterans With PTSDAaron LevinAaron LevinSearch for more papers by this authorPublished Online:19 Jan 2007https://doi.org/10.1176/pn.42.2.0004aPosttraumatic stress disorder (PTSD) is closely linked to physical symptoms in soldiers a year after their return from Iraq, even after controlling for wounds or injuries.Combat veterans reporting significant symptoms of either physical illness or PTSD should be evaluated for both conditions, said the latest report on postcombat mental health from the Walter Reed Institute of Research in Silver Spring, Md. The study was published in the January American Journal of Psychiatry.The researchers sur veyed 2,863 soldiers from four U.S. Army combat infantry brigades a year after their return from duty in Iraq. The soldiers were asked about their overall health, as well as alcohol misuse, symptoms of depression and PTSD, sick-call visits, missed work days, and somatic symptoms. Unlike with most screening questionnaires, the soldiers responded anonymously. Soldiers completed the 17-item National Center for PTSD Checklist, the Patient Health Questionnaire Depression Scale–9, and an alcohol screening test. The Patient Health Questionnaire–15 was used to assess somatic symptoms.About 80 percent of the participants were under age 30, 97 percent were male, 56 percent were enlisted personnel, and 17 percent had been injured or wounded.Overall prevalence of PTSD was 16.6 percent. A comparable group of soldiers recorded a prevalence of 5 percent before deployment. However, of those wounded or injured at least once, 31.8 percent (150 of 471) met PTSD criteria, compared with 13.6 percent (311 of 2,287) of unwounded troops (odds ratio=2.97).The veterans who screened positive for PTSD also had poor self-rated health, two or more sick-call visits, and two or more missed workdays even after controlling for combat injuries.About 47 percent of soldiers screening positive for PTSD rated their physical health as fair or poor, compared with 20 percent of those who screened negative. Also, 71 percent of those with PTSD reported sleep problems, compared with 26 percent without PTSD (see chart).“Approximately one-third of the soldiers who screened positive for PTSD had high somatic symptom severity.. .confirming the strong association between PTSD and indicators of physical health independent of physical injury,” wrote Charles Hoge, M.D., and colleagues from Walter Reed.This association may be mediated by biological, psychological, behavioral, or attentional processes, they suggested.The study may be limited by its reliance on self-reports rather than clinician interviews. Although the respondents were not selected randomly, they do represent soldiers who have been most heavily exposed to combat.The results may also be a conservative reflection of the soldiers' health since those who might have been hospitalized or going to medical appointments on the days the surveys were taken were excluded.Physicians and other health professionals in the military services, the Department of Veterans Affairs, and civilian primary and specialty practices should evaluate both the physical and mental health of combat veterans, Hoge and his team concluded.“Association of Posttraumatic Stress Disorder With Somatic Symptoms, Health Care Visits, and Absenteeism Among Iraq War Veterans” is posted at<www.ajp.psychiatryonline.org/cgi/content/full/164/1/150>.▪ ISSUES NewArchived

An investigation of the prevalence of depressive symptoms in soldiers during military training

Objectives A cross-sectional study was conducted to determine the prevalence of depressive symptoms in soldiers during military training in Chinese army and to identify associations between depressive symptoms and socio-demographic characteristics. Methods The self-rating depression scale (SDS) was used to assess self-reported experiences of depression among 1107 young adult males during military training. The following socio-demographic variables are considered as independent variables: age, service time, settlement type, education, levels of family income, family type, education of parents, health status, history of negative accidents, social support status and hobby status. A logistic regression model was used to estimate the association of these variables with depressive symptoms. Results 25.20% ( n = 279) of the servicemen had depressive symptoms. The soldiers who had high education level (OR = 1.74; 95%CI: 1.37–2.12), come from city or town (OR = 1.39; 95%CI: 1.18–1.61), have served in army for a shorter time (OR = 1.63; 95%CI: 1.43–1.88), had head ache during training course (OR = 1.39; 95%CI: 1.12–2.09), had abdomen ache or diarrhea during training course (OR = 1.85; 95%CI: 1.47–2.13) and had training injury during training course (OR = 1.67; 95%CI: 1.29–1.83) are associated with depressive symptoms. Conclusions There was a high prevalence rate of depressive symptoms among soldiers during military training. Special attention should be paid to avoiding depressive symptoms in those who have high education level, come from city or town, have served in army for a shorter time and have health problems during training course.

Relationship between serum lipid concentrations and posttraumatic stress disorder symptoms in soldiers with combat experiences.

The aim of our study was to assess concentrations of serum cholesterol, low-density lipoprotein cholesterol (LDL-C), high-density lipoprotein cholesterol (HDL-C), and triglycerides in soldiers with combat-related posttraumatic stress disorder (PTSD), in comparison with combat-experienced soldiers without PTSD. The second aim of our study was to explore the relationship between PTSD symptoms such as re-experiencing, avoidance, increased arousal, and serum lipid levels. In 53 soldiers with combat-related PTSD and 49 with combat experiences without PTSD, serum cholesterol, LDL-C, HDL-C, and triglycerides were assayed by an enzyme-assay method. Soldiers with combat-related PTSD were found to have significantly higher concentrations of cholesterol (P = 0.001), LDL-C (P = 0.002), and triglycerides (P = 0.001) than soldiers without current PTSD. HDL-C was statistically lower (P < 0.001) in soldiers with combat-related PTSD than in those without PTSD. A positive correlation was found between increased arousal and cholesterol (r = 0.464; P = 0.039), or LDL-C (r = 0.479; P = 0.021) concentrations.

Helicobacter pylori infection in Desert Storm troops.

To determine whether military personnel deployed outside the United States are at increased risk of Helicobacter pylori infection, we evaluated U.S. Army personnel who served in the Persian Gulf from August 1990 to April 1991. Of 204 subjects from whom paired predeployment and postdeployment serum specimens were obtained, 76 (37%) were seropositive for IgG antibody to H. pylori before deployment by an enzyme-linked immunosorbent assay. Of the 111 initially seronegative subjects evaluated before and after a 7.5-month deployment, five (4.5%) seroconverted. The calculated annual seroconversion rate was 7.3%. In a postdeployment questionnaire, 62% of soldiers reported an episode of diarrhea while deployed, but there was not an increased rate of diarrhea or upper gastrointestinal symptoms in soldiers who were infected before deployment or in those who seroconverted. These data suggest that the risk of H. pylori infection increases during long-term deployment and that acute infection is not distinguishable from other gastrointestinal illnesses encountered during deployment.