Identifying and managing posttraumatic stress disorder.

Posttraumatic stress disorder (PTSD) occurs in an estimated 8% of men and 20% of women who are exposed to traumatic events. PTSD is a trauma- and stress-related disorder associated with significant psychosocial morbidity, substance abuse, and other negative physical health outcomes. The hallmarks of PTSD include exposure to a traumatic event; reexperiencing the event or intrusion symptoms; avoidance of people, places, or things that serve as a reminder of the trauma; negative mood and thoughts associated with the trauma; and chronic hyperarousal symptoms.

Importance of anonymity to encourage honest reporting in mental health screening after combat deployment.

Context: US soldiers are required to undergo screening for depression, posttraumatic stress disorder (PTSD), and other mental health problems on return from service in Iraq or Afghanistan as part of routine postdeployment health assessments.

Objective: To assess the influence of the anonymity of screening processes on willingness of soldiers to report mental health problems after combat deployment.

Design: Anonymous and nonanonymous surveys.

Effectiveness of battlefield-ethics training during combat deployment: a programme assessment.

Background: Breakdowns in the ethical conduct of soldiers towards non-combatants on the battlefield are of grave concern in war. Evidence-based training approaches to prevent unethical conduct are scarce. We assessed the effectiveness of battlefield-ethics training and factors associated with unethical battlefield conduct.

Effectiveness of mental health screening and coordination of in-theater care prior to deployment to Iraq: a cohort study.

Objective: The authors assessed the effectiveness of a systematic method of predeployment mental health screening to determine whether screening decreased negative outcomes during deployment in Iraq's combat setting.

Method: Primary care providers performed directed mental health screenings during standard predeployment medical screening. If indicated, on-site mental health providers assessed occupational functioning with unit leaders and coordinated in-theater care for those cleared for deployment.

Ethical considerations in military psychiatry.

Military psychiatrists are faced with multiple, difficult questions that shape the context for ethical patient care. These questions are difficult to answer and future efforts, including policy and evidence-based treatment practices, should aim at reducing the ambiguity faced by military psychiatrists. New research should focus on issues as diverse as optimal approaches to informed consent, evidence-derived approaches to protecting confidentiality, outcomes of care for individuals in widely varying military roles, and medication use in the field.

Military family physician attitudes toward treating obesity.

Objective: The goal was to examine current knowledge, attitudes, and treatment practices of family practitioners regarding obesity.

Methods: A cross-sectional, anonymous, self-report survey of active members of the Uniformed Services Chapter of the American Academy of Family Physicians was performed. Measures included demographic information, attitudes toward obese patients, knowledge of associated health risks, and treatment recommendations, rated on a 5-point Likert scale.

Soldier attitudes toward mental health screening and seeking care upon return from combat.

Objective: This study examined soldier attitudes about postdeployment mental health screening, treatment, barriers to care, strategies for overcoming barriers, and settings, personnel and timing for conducting postdeployment mental health screening.

Methods: Deploying soldiers participated in a voluntary anonymous survey.

Results: Of 3,294 soldiers, 2,678 (81.

Postdeployment Health Reassessment: a sustainable method for brigade combat teams.

Objective: The Postdeployment Health Reassessment (PDHRA) was mandated in 2006 and the 3rd Infantry Division was the first unit to perform a large-scale implementation. This article outlines a reproducible model for conducting PDHRA using only existing resources.

Methods: The PDHRA (DD 2900) screening and referral processes are reviewed and data on positive screens are reported.

The evolving role of the division psychiatrist.

With the recent restructuring of Army infantry divisions in the new brigade combat team model, division psychiatrists are facing new and unique demands. This article outlines the varying perspectives of the position and the duties and responsibilities of a division psychiatrist. It provides guidance on how to negotiate the myriad of challenges unique to the position.

Division mental health in the new brigade combat team structure: part II. Redeployment and postdeployment.

Objective: Recent Army transformation has led to significant changes in roles and demands for division mental health staff members. This article focuses on redeployment and postdeployment.

Methods: The postdeployment health assessment behavioral health screening and referral process and redeployment plan are reviewed, and data on postdeployment rates of negative events are reported.

Division mental health in the new brigade combat team structure: part I. Predeployment and deployment.

Objective: Recent Army transformation has led to significant changes in roles and demands for division mental health (DMH) staff members. This article focuses on predeployment and deployment.

Methods: Surveillance of Combat and Operational Stress Reactions data, review of DMH implementation plans, and observations by staff members, providers, and soldiers were reviewed.

Injury patterns in peacekeeping missions: the Kosovo experience.

Proper medical deployment planning requires projecting injuries. For this reason, the injury patterns and mechanism of injury were reviewed for an 18-month period in Kosovo, and injury rates and mechanisms were extracted for review. Overall, there were 404 trauma patients treated during the study period.