Explanations for the increase in mental health problems in UK reserve forces who have served in Iraq

Browne, Tess; Hull, Lisa; Horn, Oded; Jones, Margaret; Murphy, Dominic; Fear, Nicola T.; Greenberg, Neil; French, Claire; Rona, Roberto J.; Wessely, Simon; Hotopf, Matthew

doi:10.1192/bjp.bp.106.030544

Cited by 151 publications

(137 citation statements)

References 14 publications

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“…This contrasts with a number of recent studies in other military populations [32,104,180]. Although prevalence estimates were similar to those for ADF members who deployed as regulars, the results reported here are based on small numbers deploying as reserves on CFTS.…”

Section: Discussioncontrasting

confidence: 55%

Physical comorbidities of post‐traumatic stress disorder in Australian Vietnam War veterans

McLeay

Harvey

Romaniuk

et al. 2017

Medical Journal of Australia

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Section: Discussioncontrasting

confidence: 55%

Physical comorbidities of post‐traumatic stress disorder in Australian Vietnam War veterans

McLeay

Harvey

Romaniuk

et al. 2017

Medical Journal of Australia

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“…This is in keeping with the previous findings in this sample of better mental health outcomes among Special Forces indicated by lower rates of hazardous drinking, smoking, GHQ caseness and multiple physical symptoms, despite higher rates of combat exposure [20,[25][26][27]. UK military reservists and US National Guard also experienced more mental health problems than regular personnel [14,28,29]. Differences in intensity of training and in physical and mental health status of the groups prior to deployment were thought to contribute to the poorer mental health outcomes among reservists [14].…”

Section: Discussionsupporting

confidence: 79%

Fatigue symptoms in Sri Lanka Navy personnel deployed in combat areas

Hanwella¹,

Jayasekera²,

Silva

2014

Ceylon Med. J.

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Objectives The objective was to study the prevalence of fatigue symptoms among Special Forces and regular forces military personnel deployed in combat areas and to explore factors associated with fatigue symptoms.Methods This is a cross sectional study of representative samples of Sri Lanka Navy Special Forces and regular forces deployed in combat areas continuously for at least one year. Fatigue was measured using a 12 item fatigue scale. Symptoms of common mental disorder were identified using the General Health questionnaire 12 (GHQ-12). Multiple physical symptoms were elicited using a checklist of symptoms. PTSD was diagnosed using the 17-item National Centre for PTSD checklist civilian version (PCL-C).Results Sample consisted of 259 Special Forces and 412 regular navy personnel. Prevalence of fatigue over the last month was 13.41% (95% CI 10.83-16.00). Prevalence was significantly less in the Special Forces (5.4%) than in the regular forces (18.4%) [OR 0.38 (95% CI 0.17-0.82)]. Only two types of combat exposure "thought I might be killed" and "coming under mortar, missile and artillery fire" were significantly associated with fatigue symptoms. Fatigue was strongly associated with symptoms of common mental illness [adjusted OR 12.82 (95% CI 7.10-23.12)], PTSD [adjusted OR 9.08 (95% CI 2.84-29.0)] and multiple somatic symptoms ]. Fatigue was significantly associated with functional impairment.Conclusions Prevalence of fatigue was significantly lower in the Special Forces despite high combat exposure. Fatigue was associated only with indicators of intense combat exposure. Fatigue caused significant functional impairment even after adjusting for psychological morbidity.

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“…The PTSD health effect disappeared only when adjustment was made for problems at home. One explanation for the increase in adverse health outcomes is that, for reservists at least, adverse domestic experiences may be exacerbating and prolonging PTSD symptoms (Browne 2007). Qualitative work confirms that marital problems are a common concern among reservists, many of whom felt that their families did not have access to adequate welfare services during their deployment (Eversden-French 2007).…”

Section: Uk Reservists Deployed To Iraqmentioning

confidence: 78%

“…The authors concluded that there is evidence of a clinically and statistically sig nificant adverse effect on health in reservists. In a more detailed analysis, Browne et al (2007) found significant unadjusted odds ratios for five negative health outcomes: common mental disorders, PTSD, fatigue, multiple symptoms, and fair or poor health on the Short Form-36 questionnaire. Compared with regular service personnel, reservists reported higher levels of self-perceived risk to life and trauma in theatre, and lower unit cohesion.…”

Section: Uk Reservists Deployed To Iraqmentioning

confidence: 99%

Mental health of regular and reserve military veterans

Iversen

Greenberg²

2009

Adv. psychiatr. treat

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SummaryThe psychiatric problems of combat returnees are a topical and important issue given the ongoing conflicts in Iraq and Afghanistan. Despite the media prominence afforded to post-traumatic stress disorder, the most common disorders in the UK armed forces post-deployment are depression, alcohol misuse and anxiety disorders. Although the majority of service personnel do well after leaving military life, a minority who leave with psychiatric problems appear to be at risk of social exclusion and ongoing ill health. Reserve veterans are at greater risk as they do not have access to the usual support networks of the regular military. Steps to improve the knowledge and expertise of primary care services about veterans' mental health issues and increasing the availability of treatment options are important and are underway.

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Explanations for the increase in mental health problems in UK reserve forces who have served in Iraq

Abstract: The increased ill-health of reservists appears to be due to experiences on deployment and difficulties with homecoming.

Cited by 151 publications

References 14 publications

Physical comorbidities of post‐traumatic stress disorder in Australian Vietnam War veterans

Physical comorbidities of post‐traumatic stress disorder in Australian Vietnam War veterans

Fatigue symptoms in Sri Lanka Navy personnel deployed in combat areas

Mental health of regular and reserve military veterans

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