Overview of the Unites States Air Force Suicide Prevention Program and Implications for Korean Armed Forces / 신경정신의학

Suicide is a major public health problem among Korean military personnel. As multiple factors and their interactions are related to suicide, multicomponent intervention might be useful for reducing suicide and suicide-related outcomes. The United States Air Force Suicide Prevention Program (AFSPP) launched in 1996 is a good example of an evidence-based multifaceted program focusing on leadership involvement and whole community-level efforts. For early identification and management of an at-risk population, AFSPP aims to encourage help-seeking and reduce stigma by changing the community's social norms regarding mental health and suicide. The present study reviewed the key elements of this successful intervention and made a proposal for improving the suicide prevention strategy in the Korean armed forces. This review might be useful for establishing a comprehensive intervention in local communities and organizations outside of the military.

Portuguese version of the PTSD Checklist-Military Version (PCL-M) - II: diagnostic utility

Objective: War veterans are at high risk of developing posttraumatic stress disorder (PTSD), and the development of brief self-report instruments that enable screening for PTSD in this population is crucial. The PTSD Checklist-Military Version (PCL-M) is widely used for this purpose. This study sought to explore the diagnostic utility of the Portuguese version of the PCL-M. Methods: The participants were 86 Portuguese Colonial War veterans (42 with a PTSD diagnosis and 44 without PTSD). Participants completed a self-report instrument designed to collect sociodemographic data, the PCL-M, and the Clinician-Administered PTSD Scale (CAPS). Results: The area under the receiver operator characteristic (ROC) curve showed excellent discriminant ability between subjects with and without PTSD (AUC = 0.94). To achieve a positive PTSD diagnosis, an optimal cutoff point of 49 for the PCL-M total score and cutoff points for each of its 17 items are recommended. Conclusions: This work is a relevant contribution for research and clinical practice in the vast population of Portuguese Colonial War veterans. Use of the PCL-M as a screening tool for PTSD symptoms will allow easier, resource-aware targeting of subjects with a potential PTSD diagnosis, adding to the improvement of public health in Portugal. .

Looking back and ahead: some perspectives of military psychiatry

Military psychiatry is a branch of psychiatry that is concerned with the mental health of soldiers and their families in war and peace time. It emerged as a special field of importance after World War I. With changing combat scenarios, peace keeping operations and terrorism modern soldier is obliged to confront and endure wide ranging demands for adjustment; with battle fronts becoming diffuse and coming closer to home unarmed civilians are sucked into war like situations. Military sychiatrists as well as their civilian counter parts need to be aware of the essentials of the mental health consequences of military operations of various kinds and related situations.

The Temperament and Character of Korean Male Conscripts with Military Maladjustment-A Preliminary Study

OBJECTIVE: Recently, an increasing number of Korean male conscripts have been retiring because of military maladjustment despite the presence of qualifying medical and psychological screening tests in the Korean army. These problems suggest the presence of a common personality problem. To further examine this possibility, the present study used Cloninger's psychobiological model to investigate the temperament and character of soldiers suffering from military maladjustment. METHODS: Seventy-nine maladjusted male conscripts and eighty-seven controls enrolled at the 1596th unit from April 2011 to June 2012 participated in the present study. To measure participant personality, we used the Korean version of the Temperament and Character Inventory, Revised-Short. We used logistic regression analysis to examine the association between TCI-RS scores and risk of military maladjustment. RESULTS: The maladjustment group had a lower rank, socioeconomic status, education level, and a shorter duration of military service than the control group. The harm avoidance and self-transcendence scores were significantly higher in the maladjustment group, with lower scores for reward dependence, persistence, self-directedness, and cooperativeness scores. However, of these measures, only low cooperativeness was associated with an increased risk of military maladjustment. CONCLUSION: These results suggest that a low level of cooperativeness can predict military inadequacy. Maladjusted male conscripts may have different personality characteristics from normals. To validate our results, further follow-up or cohort studies with a larger sample will be required.

Pychotropic drugs for sleep regulation and anti-fatigue in aircrew members during wartime / 第二军医大学学报

In modern war, psychotropic drugs, including central stimulants and central depressants, have profound influence on the mental states of soldiers. This paper reviews the pharmacokinetics, pharmacological mechanisms and efficacy of psychotropic drugs: and also introduces the application of psychotropic drugs for sleep regulation and anti-fatigue in aircrew members during Iraqi war, South Atlantic Campaign, Libyan Air Strike and Gulf War. Suggestions are given on proper use of psychotropic drugs in wartime.

Trastorno por estrés postraumático: estudios en veteranos de guerra norteamericanos y su relevancia para América Latina / Posttraumatic stress disorder: american veterans studies and their relevance for Latin America

Although known since time immemorial, psychiatric symptoms related to combat exposure and other war experiences have only been systematically studied in recent decades. Posttraumatic Stress Disorder (PTSD) was formally included as an autonomous clinical entity, only in the 1980's Third Edition of the American Psychiatric Association's Diagnostic and Statistical Manual of Mental Disorders (DSM-III). Most of the information on which this inclusion was based originated from studies with American veterans of the Vietnam War (1965-1975). Diagnostically, the concept of traumatic event has been expanded to experiences other than combat exposure, and presently the inclusion of PTSD among the anxiety disorders is questioned. Recent epidemiological findings are examined, with prevalence figures between 12 and 30 %, 15 to 25 % evolving into chronicity and an equally high number of veterans becoming victims of serious social problems. Clinical correlates between PTSD and other psychiatric disorders and its cultural implications have also been studied. Future research will focus on neurobiological and neuroimaging studies, multidimensional treatment approaches, and cultural-epidemiological studies applied to other traumatic experiences. In all these fields, it is estimated that Latin American psychiatry's contributions will have a significant impact.

Aun cuando se han descrito desde tiempo inmemorial síntomas psiquiátricos vinculados a la experiencia de guerra, su sistematización clínica y diagnóstica data solamente de algunas décadas atrás. En su versión moderna, el llamado Trastorno por Estrés Postraumático (TEPT) fue incluido por primera vez como categoría nosológica independiente en la tercera edición del Manual Diagnóstico y Estadístico de la Asociación Psiquiátrica Americana (DSM-III) en 1980. Los estudios previos a esta inclusión y muchos de los que les han sucedido provienen de investigaciones realizadas con veteranos norteamericanos de la Guerra de Vietnam (1965-1975). Desde el punto de vista diagnóstico, el concepto de trauma se ha expandido a una variedad de experiencias y, en el momento actual, se cuestiona la inclusión de TEPT entre los llamados trastornos ansiosos. Se examina y discute los hallazgos epidemiológicos más recientes con niveles de prevalencia que oscilan entre 12% y 30 %, con un 15% a 25 % evolucionando hacia la cronicidad y cifras igualmente altas de veteranos víctimas de severos problemas sociales. Clínicamente, se ha estudiado correlaciones del TEPT con otras entidades psiquátricas y las implicaciones culturales del trastorno. La investigación futura en torno al TEPT incidirá en estudios neurobiológicos, neuroimagenológicos y tratamientos multidimensionales así como en afrontes epidemiológico-culturales extendidos a otras experiencias traumáticas. En todos estos terrenos se considera que la contribución latinoamericana ha de tener un impacto significativo.

The status and prospects of psychiatric / 解放军医学杂志

Objective To summarize the progresses in psychological medicine made domestically and abroad,especially in PLA,during the period of "Eleventh Five-Year Plan" ,and propose a suggestion for the development of psychological medicine in the period of "Twelfth Five-Year Plan".Methods To retrospectively review and summarize the literature concerning psychological medicine and related subjects published domestically and abroad in past 5years retrieved from PubMed and CNKI.Results During the period of "Eleventh Five-Year Plan" ,researches on psychological medicine and related subjects had become one of the hot topics receiving agreat deal of attention by the governments and academic circles all over the world.New progresses had been achieved in the fields of psychological medicine services,epidemiological researches,networking psychiatry,etiology and pathological mechanism of mental illness,researches in treatment,stress disorder,and mental health in general hospitals,etc.In PLA,the incidence of schizophrenia and other serious mental illnesses declined significantly,but the prevalence rate of anxiety and depression showed a rising trendency among servicemen in peacetime. The development of military psychological medicine was affected in some extent by the organizational system and adjustment of organizational structure of the army.There still existed some problems to be improved such as the lack of high-tech personnel and staff training.Conclusions The great changes in socio-economics and culture produced a new demand on mental health services.The hot spots of researches of psychological medicine will still focus on biological psychiatry,the treatment of mental illness,social psychiatry and development of psychology,etc.