BackgroundThe mental health of the Armed Forces is an important issue of both academic and public interest. The aims of this study are to: a) assess the prevalence and risk factors for common mental disorders and post traumatic stress disorder (PTSD) symptoms, during the main fighting period of the Iraq War (TELIC 1) and later deployments to Iraq or elsewhere and enlistment status (regular or reserve), and b) compare the prevalence of depression, PTSD symptoms and suicidal ideation in regular and reserve UK Army personnel who deployed to Iraq with their US counterparts.MethodsParticipants were drawn from a large UK military health study using a standard two phase survey technique stratified by deployment status and engagement type. Participants undertook a structured telephone interview including the Patient Health Questionnaire (PHQ) and a short measure of PTSD (Primary Care PTSD, PC-PTSD). The response rate was 76% (821 participants).ResultsThe weighted prevalence of common mental disorders and PTSD symptoms was 27.2% and 4.8%, respectively. The most common diagnoses were alcohol abuse (18.0%) and neurotic disorders (13.5%). There was no health effect of deploying for regular personnel, but an increased risk of PTSD for reservists who deployed to Iraq and other recent deployments compared to reservists who did not deploy. The prevalence of depression, PTSD symptoms and subjective poor health were similar between regular US and UK Iraq combatants.ConclusionThe most common mental disorders in the UK military are alcohol abuse and neurotic disorders. The prevalence of PTSD symptoms remains low in the UK military, but reservists are at greater risk of psychiatric injury than regular personnel.
The renewed interest in the care and treatment of chronic psychiatric patients has led to an awareness of the need for improved assessment methods for this group. This article describes the development of REHAB, a behavior rating scale for use with people with chronic psychiatric disability, which has been carefully designed with respect to content, format, and ease of use. The article also draws together the various factor-analytic, reliability, validity, and sensitivity-to-change studies that provide the basic psychometric evidence for the scale's value. REHAB is presented as an integrated package of materials with special attention paid to training of raters and simplicity of interpretation. It has been used for a variety of different assessment purposes, in both research and clinical settings.
The effect of osmotic cell swelling on the permeability of HeLa cells to a range of structurally unrelated solutes including taurine, sorbitol, thymidine, choline, and K+ (96Rb+) was investigated. For each solute tested, reduction in the osmolality of the medium from 300 to 200 mosmol/kgH2O caused a significant increase in the unidirectional influx rate. In each case, the osmotically activated transport component was nonsaturable up to external substrate concentrations of 50 mM. Inhibitors of the swelling-activated anion channel of HeLa cells [quinine, 4,4'-diisothiocyanostilbene-2,2'-disulfonic acid, niflumate, 1,9-dideoxyforskolin, 5-nitro-2-(3-phenylpropylamino)benzoic acid (NPPB), and tamoxifen] blocked the osmotically activated influx of each of the different substrates tested, as well as the osmotically activated efflux of taurine and I-. Tamoxifen and NPPB were similarly effective at blocking the osmotically activated efflux of 96Rb+. The simplest of several hypotheses consistent with the data is that the osmotically activated transport of the different solutes tested here is via a swelling-activated anion-selective channel that has a significant cation permeability and a minimum pore diameter of 8-9 A.
Psychiatrists, psychologists, and nursing staff are increasingly making direct observations and ratings of ward behaviour. Characteristically, a nurse may be asked to complete a multi-item rating scale on a group of patients during the course of a drug trial. Several factors are involved in the choice of an appropriate scale for a particular purpose. Among these factors are the number of points per item, which defines the sensitivity to change of the item, and the total number of items in the scale, which affects the time taken to complete the scale and hence the frequency of rating that can be permitted in an assessment schedule.
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