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ABSTRACTS continued

Hoge, C. W., Auchterlonie, J. L., & Milliken, C. S. (2006). Mental health problems, use of mental health services, and attrition from military service after returning from deployment to Iraq or Afghanistan. Journal of the American Medical Association, 295, 1023-1032. The US military has conducted population-level screening for mental health problems among all service members returning

study aimed to determine the relationship between combat deploy-

and to assess the lessons learned from the postdeployment mental health screening effort, in a population-based sample of Army soldiers and Marines who completed the routine postdeployment health assessment between May 1, 2003, and April 30, 2004, on return from deployment to Operation Enduring Freedom in

Afghanistan (n and other locations (n

n = 222,620),

occupational outcomes were measured for 1 year after deployment or until leaving the service if this occurred sooner. The prevalence

(P<.001). Mental health problems reported on the postdeployment

mental health care referral and utilization, and attrition from military

referred for a mental health reason were documented to receive

who received mental health treatment were referred through the

utilization of mental health services and attrition from military service after deployment. The deployment mental health screening program provided another indicator of the mental health impact of deployment on a population level but had limited utility in predicting the level of mental health services that were needed after deployment. [abstract adapted]

& Koffman, R. L. (2004). Combat duty in Iraq and Afghanistan, mental health problems, and barriers to care. New England Journal of Medicine, 351, 13-22. Studies are needed to systemati- cally assess the mental health of members of the armed services and to inform policy with regard to the optimal delivery of mental health care to returning veterans. We studied members of four U.S. combat infantry units (three Army units and one Marine Corps unit)

n = 2,530) or 3 to 4 months n

PTSD, which were evaluated on the basis of standardized, self- administered screening instruments. Exposure to combat was

among those deployed to Afghanistan. The percentage of study

was in the rate of PTSD. Of those whose responses were positive

Those whose responses were positive for a mental disorder were twice as likely as those whose responses were negative to report concern about possible stigmatization and other barriers to seeking mental health care. [abstract adapted]

Hoge, C. W., Terhakopian, A., Castro, C. A., Messer, S. C., & Engel,

Association of posttraumatic stress disorder with somatic symptoms, health care visits, and absenteeism among Iraq war veterans. American Journal of Psychiatry, 164, 150-153.

association with physical health has not been well studied. The authors studied 2,863 soldiers using standardized self-administered screening instruments 1 year after their return from combat duty in

health, more sick call visits, more missed workdays, more physical symptoms, and high somatic symptom severity. These results

medical burden of PTSD includes physical health problems; combat veterans with serious somatic concerns should be evaluated for PTSD. [abstract adapted]

(2006). The health of UK military personnel who deployed to

the 2003 Iraq War: A cohort study. Lancet, 367,


compared health outcomes in a random sample of UK armed forces

personnel who were not deployed. Participants completed a

outcomes, which included symptoms of PTSD, common mental disorders, general wellbeing, alcohol consumption, physical


n = 5,550) in the

non-deployed sample. Differences in health outcomes between groups were slight. There was a modest increase in the number of individuals with multiple physical symptoms. No other differences between groups were noted. The effect of deployment was different

multiple physical symptoms was weakly associated with deployment, whereas for reservists deployment was associated with common mental disorders and fatigue. There was no evidence that later deployments, which were associated with escalating insurgency and UK casualties, were associated with poorer mental health outcomes. [abstract adapted]

Earnshaw, M., et al. (2008). Risk factors for post-traumatic stress disorder among UK armed forces personnel. Psychological Medicine, 38, 511-522. This study aimed to investigate the relative contribution of demographic variables; childhood adversity; the nature of exposure to traumatic events during deployment; appraisal of these experiences; and home-coming experiences in relation to the prevalence of PTSD ‘caseness’ as measured by a score of 50 on the PTSD Checklist (PCL) in UK Armed Forces personnel who have

stage of a retrospective cohort study comparing UK military

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