Search

Mental disorders and alcohol misuse are often comorbid, and this comorbidity is more common in those who develop mental disorders following exposure to traumatic events. To investigate the relationship between combat exposure and operational role (support versus combat) with mental disorders and associated comorbidity in a UK military cohort. 4896 participants from a UK military cohort reported their operational role and frequency of exposure to combat events during deployment. Outcome measures included self-reported post-traumatic stress disorder, common mental disorder and alcohol misuse. Personnel reporting higher levels of combat exposure were more likely to meet criteria for two or more co-occurring mental disorders (odds ratio [OR] 3.90, 95% confidence interval [CI] 2.73–5.58). While having a combat role increased the risk of developing co-occurring disorders compared to having a support role (OR 1.67, 95% CI 1.26–2.23), this effect diminished following adjustment for variables including combat exposure (OR 0.89, 95% CI 0.62–1.27). Combat exposure may play a greater role in the development of comorbid mental disorders than operational role, i.e. job title. Clinicians treating military personnel should be alert to the increased risk of comorbid mental disorders and alcohol misuse among those with a history of combat exposure. [ABSTRACT FROM AUTHOR]

Objectives: (1) To investigate factors associated with intention to self‐isolate, request a test, and share details of close contacts when required. (2) To determine whether associations were stronger during periods when less stringent national COVID‐19 restrictions were in place. Design: Series of cross‐sectional nationally representative surveys. We selected survey waves where different national restrictions were in place in England (first lockdown, summer release, second lockdown, third lockdown). Methods: We investigated whether psychological factors and increased out‐of‐home activity in the last week were associated with intention to self‐isolate and request a test if you were to develop COVID‐19 symptoms, and intention to share details of contacts if you were to test positive. We also investigated whether the strength of associations differed by timepoint in the pandemic. Results: Intention to self‐isolate, request a test and share details of contacts were associated with greater perceived risk of COVID‐19 to people in the United Kingdom, knowing that COVID‐19 transmission can be asymptomatic, and agreeing that personal behaviour has an impact on COVID‐19 transmission. There were few differences in strength of associations by timepoint suggesting these effects are broadly stable over time. Conclusions: Psychological factors were associated with intention to adhere to key components of the contact tracing system; there was no evidence for an association with increased out‐of‐home activity. Messages that increase knowledge that COVID‐19 can be transmitted even if someone does not have symptoms and that an individual's actions can contribute to the spread of the virus may promote engagement with the test, trace, and isolate system. [ABSTRACT FROM AUTHOR]

Background: Little is known about longer term military work outcomes in UK military personnel who develop mental health problems when operationally deployed. Deployed Field Mental Health Teams (FMHTs) who support them follow the principles of 'Forward Psychiatry,' aiming to treat psychiatric casualties close to the front line to maximize operational effectiveness and occupational retention. Aim: To examine the short- and long-term military work outcomes in soldiers deployed to Iraq between 2003 and 2007 who were referred to the FMHT. Method: FMHT clinical records were linked to occupational records with 825 resulting matches. Results: 71.6% of the referred soldiers with a documented short-term military work outcome returned to their operational unit, and 73.5% of those who had a documented long-term military work outcome served on for a period in excess of two years. Adjusting for potential confounders, a shorter service length and removal from the operational theatre were both strongly associated with premature discharge; however, it was not possible to determine the severity of the presenting mental health problem and assess whether this impacted outcome. Conclusions: The results of this study support the use of the Forward Psychiatry principles in achieving good short-term military work outcomes. Utilizing these principles, three-quarters of those referred to the FMHT were returned to their deployed unit and approximately three-quarters of those assessed by the FMHT remained in service two years after referral. We suggest that these are positive work outcomes; however, being evacuated out of the operational environment and having a short service length were both associated with premature discharge, though we were unable to examine the role of illness severity.

To link to full-text access for this article, visit this link: http://dx.doi.org/10.1016/j.addbeh.2008.03.010 Byline: Richard Hooper (a), Roberto J. Rona (b), Margaret Jones (b), Nicola T. Fear (c), Lisa Hull (b), Simon Wessely (b) Keywords: Alcohol consumption; Smoking; Military personnel; Psychological stress; Combat; Iraq War Abstract: Retrospective studies of military personnel and survivors of community disasters suggest a link between traumatic exposure and substance use. This is the first study to investigate this association prospectively in a military population. A representative cohort of members of the UK Armed Forces was recruited into a longitudinal study, with 1382 people surveyed at baseline, and 941 followed up around three years later. Alcohol and cigarette use were assessed on both occasions, and combat exposures during this time were assessed at follow-up. Alcohol consumption and the prevalence of binge-drinking increased over the course of the study. The increase in alcohol consumption was greater in those subjects who had been deployed, in particular in those who thought they might be killed (p =.010), or who experienced hostility from civilians while on deployment (p =.010). The effects of these combat exposures were strongest in those most recently deployed. In contrast, cigarette smoking declined during the three years of the study. Author Affiliation: (a) National Heart & Lung Institute, Imperial College London, Emmanuel Kaye Building, Manresa Road, London SW3 6LR, UK (b) King's Centre for Military Health Research, King's College London, Weston Education Centre, Cutcombe Road, London SE5 9RJ, UK (c) Academic Centre for Defence Mental Health, King's College London, Weston Education Centre, Cutcombe Road, London SE5 9RJ, UK

Objectives: To identify the prevalence of a stigmatizing attitude towards people of Chinese origin at the start of the COVID‐19 outbreak in the UK population and investigate factors associated with holding the stigmatizing attitude. Design: Online cross‐sectional survey conducted 10–13 February 2020 (n = 2006, people aged 16 years or over and living in the UK). Methods: We asked participants to what extent they agreed it was best to avoid areas heavily populated by Chinese people because of the COVID‐19 outbreak. Survey materials also asked about: worry, perceived risk, knowledge, information receipt, perception of government response to COVID‐19, and personal characteristics. We ran binary logistic regressions to investigate associations between holding a stigmatizing attitude, personal characteristics, and psychological and contextual factors. Results: 26.1% people (95% CI 24.2–28.0%, n = 524/2006) agreed it was best to avoid areas heavily populated by Chinese people. Holding a stigmatizing attitude was associated with greater worry about COVID‐19, greater perceived risk of COVID‐19, and poorer knowledge about COVID‐19. Conclusions: At the start of the COVID‐19 pandemic, a large percentage of the UK public endorsed avoiding areas in the UK heavily populated by people of Chinese origin. This attitude was associated with greater worry about, and perceived risk of, the COVID‐19 outbreak as well as poorer knowledge about COVID‐19. At the start of future novel infectious disease outbreaks, proactive communications from official sources should provide context and facts to reduce uncertainty and challenge stigmatizing attitudes, to minimize harms to affected communities. [ABSTRACT FROM AUTHOR]