Article

Do medical services personnel who deployed to the Iraq war have worse mental health than other deployed personnel?

King's Centre for Military Health Research, Institute of Psychiatry, King's College London, London, UK.
The European Journal of Public Health (Impact Factor: 2.52). 09/2008; 18(4):422-7. DOI: 10.1093/eurpub/ckn031
Source: PubMed

ABSTRACT There is evidence of increased health care utilization by medical personnel (medics) compared to other trades in the UK Armed Forces. The aim of this study was to compare the burden of mental ill health in deployed medics with all other trades during the Iraq war.
Participants' main duty during deployment was identified from responses to a questionnaire and verified from Service databases. Psychological health outcomes included psychological distress, post-traumatic stress disorder, multiple physical symptoms, fatigue and heavy drinking.
A total of 479 out of 5824 participants had a medical role. Medics were more likely to report psychological distress (OR 1.30, 95% CI 1.00-1.70), multiple physical symptoms (OR 1.65, 95% CI 1.20-2.27) and, if men, fatigue (1.38, 95% CI 1.05-1.81) than other personnel. Female medics were less likely to report fatigue (0.57 95% CI 0.35-0.92). Neither post-traumatic stress disorder nor heavy drinking symptoms were associated with a medical role. Traumatic medical experiences, lower group cohesion and preparedness, and post-deployment experiences explained the positive associations with psychological ill health. Medics made greater use of medical facilities than other trades.
There is a small excess of psychological ill health in medics, which can be explained by poorer group cohesion, traumatic medical and post-deployment experiences. The association of mental ill health with a medical role was not the consequence of a larger proportion of reservists in this group.

0 Bookmarks
 · 
115 Views
  • [Show abstract] [Hide abstract]
    ABSTRACT: This study investigated whether Critical Care Air Transport Team (CCATT) members are at increased risk for incident post-deployment mental health conditions. We conducted a retrospective cohort study of 604 U.S. Air Force medical personnel without preexisting mental health conditions who had at least one deployment as a CCATT member during 2003-2012 as compared to a control group of 604 medical personnel, frequency matched based on job role, with at least one deployment during the same period, but without CCATT experience. Electronic health record data were used to ascertain the diagnosis of a mental health condition. The incidence of post-deployment mental health conditions was 2.1 per 1000 mo for the CCATT group versus 2.2 per 1000 mo for the control group. The six most frequent diagnoses were the same in both groups: adjustment reaction not including posttraumatic stress disorder (PTSD), anxiety, major depressive disorder, specific disorders of sleep of nonorganic origin, PTSD, and depressive disorder not elsewhere classified. Women were at marginally increased risk and nurses and technicians were at twice the risk of physicians. The distribution of the time interval from end of the most recent deployment to diagnosis of incident mental health condition was positively skewed with a median greater than 6 mo. CCATT members were at no increased risk for incident post-deployment mental health conditions as compared to non-CCATT medical service members. Nearly two-thirds of incident post-deployment mental health conditions were diagnosed outside the standard 6-mo medical surveillance period, a finding warranting further study.
    Aviation Space and Environmental Medicine 01/2014; 85(1):30-8. · 0.78 Impact Factor
  • Source
    [Show abstract] [Hide abstract]
    ABSTRACT: Care for battle casualties demands special skills from medics, nurses and tactical commanders. To date, no inventory has been performed evaluating the first responders (medics, nurses and tactical commanders) around battle casualties.
    Injury 12/2014; 155. · 2.46 Impact Factor
  • [Show abstract] [Hide abstract]
    ABSTRACT: The purpose of this investigation was to understand the varied health care provider responses to traumas by identifying perceptions of control and self-efficacy, appraisal styles, and postevent coping strategies in active duty military nurses and physicians deployed to combat/terrorist regions. Twenty purposively sampled military health care providers completed a descriptive questionnaire, the Posttraumatic Stress Disorder Checklist, the General Self-Efficacy Scale, and a recorded semistructured interview that was later transcribed and content analyzed. Cognitive-behavioral determinants of healthy response to trauma were used to frame this descriptive interpretive study and to assist with developing a model for healthy adaptation in trauma-exposed health care providers. Participants felt they had the greatest control over their health care provider role in theater, and most expressed a belief that a sense of control and a sense of purpose were important to their coping. All used some form of social support to cope and many found calming activities that allowed for self-reflection to be helpful. Results from this analysis can be used to inform interventions and promote postevent coping behaviors that increase social support, strengthen important bonds, and enhance involvement in activities that elicit positive emotions. Health care providers experienced positive outcomes despite considerable traumatic exposure by using coping strategies that map closely to several principles of psychological first aid. This suggests a need to train all medical personnel in these concepts as they appear helpful in mitigating responses to the stress of combat-related exposures. (PsycINFO Database Record (c) 2013 APA, all rights reserved).
    Psychological Services 07/2013; · 1.08 Impact Factor

Full-text (2 Sources)

Download
43 Downloads
Available from
May 29, 2014