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It is a popularly held belief that psychiatric behavior worsens during a full moon. Research in this area has yielded mixed results. Records from Naval Medical Center San Diego for 1993-2001 were examined to see whether there were higher rates of psychiatric admission associated with particular phases of the moon. Records from 8,473 admissions revealed that there were no more admission on days with a full moon, a new moon, any quarter of the moon, a waxing moon, or a waning moon. This held true for psychiatric patients as a whole, as well as for individuals with particular diagnoses, such as those with a mood disorder or psychotic disorder. Records from 1,909 emergency psychiatric evaluations that occurred between 2002 and 2003 were also examined to see whether a higher percentage of patients might present, but not require hospitalization, during a particular phase of the moon. Once again, no significant effect was found. In summary, lunar phase was not associated in any significant way with psychiatric admissions or emergency presentation.

Military personnel deployed in support of combat operations are at significantly higher risk for mental health problems. However, much of what we know about combat-related mental health comes from postdeployment assessments. This study describes the mental health of 1,336 treatment-seeking deployed U.S. military personnel and interventions recommended by military mental health providers in Iraq from January 2006 to January 2007. Cases were primarily young enlisted men, most of whom were on their first combat deployment. Marines made up the majority of the cases (60%), but there were also large numbers of Army and Navy personnel. The most common psychiatric diagnoses were anxiety disorders (31%, including 11% with posttraumatic stress disorder), followed by adjustment (27%) and mood disorders (25%, including 22% with depression). Medication was the most commonly prescribed treatment for patients with psychiatric diagnoses but was often combined with recommendations for psychotherapy/counseling and/or behavioral modifications. The findings illustrate the distribution of mental health conditions seen among treatment-seeking troops while actively serving in a combat environment and the interventions recommended for them. Further examination of postdeployment health outcomes may help to facilitate the development of more effective acute intervention strategies in theater.

Research has documented higher risks for mental health problems among service members deployed to war zones, yet a research limitation has been that assessment has generally occurred often years after combat exposure. The Operational Stress Control and Readiness program integrated mental health practitioners with 1st Marine Division units serving in Iraq. This team documented mental health visits between January 2006 and January 2007 and developed the Theater Mental Health Encounter Database (TMHED). This report describes the TMHED study design, measures, and cases. Of 1336 patients (3180 patient visits), 10% were women, 75% were high school educated, 55% were mid-paygrade enlisted, and 63% were on their first combat deployment. Compared with the overall deployed population, patient percentages included higher percentages of Marines and Navy personnel but lower percentages of Army and Air Force personnel, more junior enlisted but fewer officers, and fewer college graduates. TMHED provides an unprecedented opportunity to study early psychiatric intervention in a combat zone and prospectively examines postdeployment health and career outcomes.

Mental health treatment of military service members places unique demands on providers as their patients experience combat stress. This study assessed levels and predictors of burnout among mental health providers (N = 97) at military facilities, using a self-administered survey of demographic and work-related measures and the Maslach Burnout Inventory. Burnout levels were comparable to studies of civilian mental health providers but were less severe than those of the Maslach Burnout Inventory normative sample. Working more hours, having more patients with personality disorders, increased patient caseloads, female gender, and being a psychiatrist were predictive of higher burnout scores. Having more confidants at work, a greater percentage of patients with traumatic brain injury, more clinical experience, and being a psychologist predicted lower burnout scores. These findings suggest that burnout levels among military providers are similar to those among civilian providers and may be alleviated by interventions targeting general institutional risk factors.

Admission data from 6,366 patients on the psychiatry service at Naval Medical Center San Diego were used to form a linear regression model to examine variables that might influence length of stay. Information was available on active duty status, primary diagnosis, age, gender, and marital status. Active duty service, older age, single marital status, and a primary diagnosis of a psychotic or mood disorder were all significantly associated with longer hospital stays. Primary diagnosis of an adjustment or personality disorder was associated with a shorter stay. Taking into account these variables, lengths of stay for active duty personnel averaged 4.00 ± 0.39 days longer than for equivalent civilian admissions. Although military personnel are generally thought of as a healthy population, psychiatric hospital stays were found to be longer in service members than in their civilian counterparts. Financial repercussions and possible reasons for this are discussed.