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BMJ 2006;333:1123 (25 November).
Letters
Predicting mental illness in soldiers
Pre-deployment screening for vulnerability to post- traumatic stress disorder
By: Ferhal Utku, Ken Checinski, senior lecturer in addictive behaviour

That post-traumatic stress disorder (and other mental disorders) are difficult to predict, with the implication that ex-service personnel are likely to present to civilian mental health services with such conditions.

Post-trauma debriefing is possibly harmful, so service personnel need vigilant monitoring for mental disorder after the fact.

This is particularly important when they leave the protective group environment provided by military life.

PS: I Know these are American soldiers but it illustrates very well how dangerous and stressfull life in a war zone can be.

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I just had a quick look at the rapid responses to this article in a recent BMJ. As you know, I recently did a BLOG on Predicting Mental Illness in Soldiers (https://bmjjournals.wordpress.com/2007/09/21/mental-illness-in-deployed-soldiers/ ).

It is obviously very important indeed to see what can be done to avoid MENTAL Illness in general and in Soldiers in particular as we send them on missions. Now obviously the first thing in soldiers that you could do, is stop going to silly, avoidable conflicts. Something the authors didn’t mention. But we all know that there are too many conflicts and many are about what????

Furthermore, deployment is an essential ingredient of military life, is considered a valuable feature of a military career, and for many is the reason for joining up. But at some stage any human being has reached its point of no return and will break if pushed any further. You don’t need to be a psychiatrist to know that.

An interesting response was the following comment by Dr Abraham George, SpR Public Health, Manchester :

“However, we would also like to raise a number of methodological issues: · In the Methods section, the authors stated a total 10,272 personnel (4722 deployed plus 5550 non deployed personnel) followed by sample of 5547 regulars. However, the results section states “ Overall 5547 (63.9%) out of 8686 regulars who completed the questionnaire had participated in at least one deployment in the past 3 years.” A flow chart describing the recruitment process of the study participants would have helped explain the inclusion, exclusion and response rate details. · No mention was made how the authors calculated the expected sample size of the study. · Considering that only two of the outcomes measured showed a marginal association with operational tempo, could it have been possible that sample size was found to be inadequate even though the overall response rate was good? ·

Under the Discussion section, the authors state that information bias is unlikely because the outcome measurements were objective. This is incorrect because self reported responses are subjective measures.”

Now you would think that a professor etc would know this. So I would say, a very important issue to study, but too many flaws in the study itself. Unfortunately.

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Recently a German Psychiatrist who works for the German Army stated that the main predictor of soldiers getting PTSD, Post Traumatic Stress Disorder, and other mental illnesses, was not so much the lenght away from home, even though they spend a lot more time at home than British soldiers. But that it was more if the soldiers, when presented with a dangerous or horrible situation, had the feeling they had an INFLUENCE on the outcome or not.

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bmj-after-deployment.jpg The army is taking on too many jobs, resulting in too many soldiers going off sick.

http://www.bmj.com/cgi/content/extract/335/7620/571  

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