scholarly journals O5C.3 The mental health impact of deployment to iraq and afghanistan: what does the current data show?

2019 ◽  
Vol 76 (Suppl 1) ◽  
pp. A46.1-A46
Author(s):  
Sharon Stevelink ◽  
Margaret Jones ◽  
Lisa Hull ◽  
David Pernet ◽  
Shirlee MacCrimmon ◽  
...  
Keyword(s):  
Mental Health ◽  
Mental Disorders ◽  
Health Outcomes ◽  
Alcohol Misuse ◽  
Common Mental Disorders ◽  
Health Impact ◽  
Current Data ◽  
Mental Health Outcomes ◽  
The Uk ◽  
The Impact

The longer term mental health outcomes of UK serving and ex-serving personnel have been the subject of much speculation. The latest research findings from the third phase of a longitudinal study will be presented, which is the only military cohort study of its kind in the UK. Data was collected among 8093 personnel between 2014 and 2016. The study examined the prevalence of mental disorders and alcohol misuse, whether rates differed between serving and ex-serving regular personnel and the impact of various deployment exposures. The prevalence of probable posttraumatic stress disorder was 6.2% (95% confidence interval (CI) 5.5–6.9), 21.9% (95% CI 20.8–23.0) for common mental disorders and 10.0% (95% CI 9.2–10.9) for alcohol misuse. Deployment to Iraq or Afghanistan and self-reported role during deployment were associated with significantly worse mental health outcomes and alcohol misuse in ex-serving regular personnel but not in currently serving regular personnel. There was no association with number of deployments for any outcome. The findings highlight the importance of the continued monitoring of following personnel throughout their military career and beyond. The implications of the study outcomes will be discussed in the light of the mental health provision for serving and ex-serving personnel.

scholarly journals Loneliness in the UK during the COVID-19 pandemic: Cross-sectional results from The COVID-19 Psychological Wellbeing Study

2020 ◽  
Author(s):  
Jenny Groarke ◽  
Emma Berry ◽  
Lisa Graham-Wisener ◽  
Phoebe McKenna-Plumley ◽  
Emily McGlinchey ◽  
...  
Keyword(s):  
Mental Health ◽  
Risk Factors ◽  
Emotion Regulation ◽  
Health Outcomes ◽  
Mental Health Outcomes ◽  
Psychological Wellbeing ◽  
Public Health Issue ◽  
Cross Sectional ◽  
The Uk ◽  
The Impact

Objectives: Loneliness is a significant public health issue. The COVID-19 pandemic has resulted in lockdown measures limiting social contact. The UK public are worried about the impact of these measures on mental health outcomes. Understanding the prevalence and predictors of loneliness at this time is a priority issue for research. Design: The study employed a cross-sectional online survey design. Method: Baseline data collected between March 23rd and April 24th 2020 from UK adults in the COVID-19 Psychological Wellbeing Study were analysed (N = 1963, 18-87 years, M = 37.11, SD = 12.86, 70% female). Logistic regression analysis was used to look at the influence of sociodemographic, social, health and COVID-19 specific factors on loneliness. Results: The prevalence of loneliness was 27% (530/1963). Risk factors for loneliness were younger age group (OR: 4.67 – 5.31), being separated or divorced (OR: 2.29), meeting clinical criteria for major depression (OR: 1.74), greater emotion regulation difficulties (OR: 1.04), and poor quality sleep due to the COVID-19 crisis (OR: 1.30). Higher levels of social support (OR: 0.92), being married/co-habiting (OR: 0.35) and living with a great number of adults (OR: 0.87) were protective factors. Conclusions: Rates of loneliness during the initial phase of lockdown were high. Risk factors were not specific to the COVID-19 crisis. Findings suggest that supportive interventions to reduce loneliness should prioritise younger people and those with mental health symptoms. Improving emotion regulation and sleep quality may be optimal initial targets to reduce the impact of COVID-19 regulations on mental health outcomes.

scholarly journals Mental health outcomes at the end of the British involvement in the Iraq and Afghanistan conflicts: a cohort study

2018 ◽  
Vol 213 (6) ◽  
pp. 690-697 ◽  
Author(s):  
Sharon A. M. Stevelink ◽  
Margaret Jones ◽  
Lisa Hull ◽  
David Pernet ◽  
Shirlee MacCrimmon ◽  
...  
Keyword(s):  
Mental Health ◽  
Health Outcomes ◽  
Traumatic Stress ◽  
Alcohol Misuse ◽  
Armed Forces ◽  
Mental Health Outcomes ◽  
Post Traumatic Stress ◽  
King's College ◽  
Post Traumatic ◽  
The Uk

BackgroundLittle is known about the prevalence of mental health outcomes in UK personnel at the end of the British involvement in the Iraq and Afghanistan conflicts.AimsWe examined the prevalence of mental disorders and alcohol misuse, whether this differed between serving and ex-serving regular personnel and by deployment status.MethodThis is the third phase of a military cohort study (2014–2016; n = 8093). The sample was based on participants from previous phases (2004–2006 and 2007–2009) and a new randomly selected sample of those who had joined the UK armed forces since 2009.ResultsThe prevalence was 6.2% for probable post-traumatic stress disorder, 21.9% for common mental disorders and 10.0% for alcohol misuse. Deployment to Iraq or Afghanistan and a combat role during deployment were associated with significantly worse mental health outcomes and alcohol misuse in ex-serving regular personnel but not in currently serving regular personnel.ConclusionsThe findings highlight an increasing prevalence of post-traumatic stress disorder and a lowering prevalence of alcohol misuse compared with our previous findings and stresses the importance of continued surveillance during service and beyond.Declaration of interest:All authors are based at King's College London which, for the purpose of this study and other military-related studies, receives funding from the UK Ministry of Defence (MoD). S.A.M.S., M.J., L.H., D.P., S.M. and R.J.R. salaries were totally or partially paid by the UK MoD. The UK MoD provides support to the Academic Department of Military Mental Health, and the salaries of N.J., N.G. and N.T.F. are covered totally or partly by this contribution. D.Mu. is employed by Combat Stress, a national UK charity that provides clinical mental health services to veterans. D.MacM. is the lead consultant for an NHS Veteran Mental Health Service. N.G. is the Royal College of Psychiatrists’ Lead for Military and Veterans’ Health, a trustee of Walking with the Wounded, and an independent director at the Forces in Mind Trust; however, he was not directed by these organisations in any way in relation to his contribution to this paper. N.J. is a full-time member of the armed forces seconded to King's College London. N.T.F. reports grants from the US Department of Defense and the UK MoD, is a trustee (unpaid) of The Warrior Programme and an independent advisor to the Independent Group Advising on the Release of Data (IGARD). S.W. is a trustee (unpaid) of Combat Stress and Honorary Civilian Consultant Advisor in Psychiatry for the British Army (unpaid). S.W. is affiliated to the National Institute for Health Research Health Protection Research Unit (NIHR HPRU) in Emergency Preparedness and Response at King's College London in partnership with Public Health England, in collaboration with the University of East Anglia and Newcastle University. The views expressed are those of the author(s) and not necessarily those of the National Health Service, the NIHR, the Department of Health, Public Health England or the UK MoD.

scholarly journals Do Junior Entrants to the UK Armed Forces have worse outcomes than Standard Entrants?

2021 ◽  
pp. bmjmilitary-2021-001787
Author(s):  
Margaret Jones ◽  
N Jones ◽  
H Burdett ◽  
B P Bergman ◽  
N T Fear ◽  
...  
Keyword(s):  
Mental Health ◽  
Mental Disorders ◽  
Alcohol Misuse ◽  
Common Mental Disorders ◽  
Armed Forces ◽  
Physical Symptoms ◽  
Self Report ◽  
Adult Service ◽  
Self Harm ◽  
The Uk

IntroductionThe UK is the only permanent member of the UN Security Council that has a policy of recruiting 16 and 17 year old individuals into its regular Armed Forces. Little is known about the consequences of enlisting as a Junior Entrant (JE), although concerns have been expressed. We compare the mental health, deployment history, and pre-enlistment and post-enlistment experiences of personnel who had enlisted as JEs with personnel who joined as Standard Entrants (SEs).MethodParticipants from a large UK military cohort study completed a self-report questionnaire between 2014 and 2016 that included symptoms of probable post-traumatic stress disorder (PTSD), common mental disorders, alcohol consumption, physical symptoms and lifetime self-harm. Data from regular non-officer participants (n=4447) from all service branches were used in the analysis. JEs were defined as having enlisted before the age of 17.5 years. A subgroup analysis of participants who had joined or commenced adult service after April 2003 was carried out.ResultsJEs were not more likely to deploy to Iraq or Afghanistan but were more likely to hold a combat role when they did (OR 1.25, 95% CI 1.00 to 1.56). There was no evidence of an increase in symptoms of common mental disorders, PTSD, multiple somatic symptoms (MSS), alcohol misuse or self-harm in JEs in the full sample, but there was an increase in alcohol misuse (OR 1.84, 95% CI 1.18 to 2.87), MSS (OR 1.51, 95% CI 1.04 to 2.20) and self-harm (OR 2.13, 95% CI 1.15 to 3.95) in JEs who had commenced adult service after April 2003. JEs remain in adult service for longer and do not have more difficulties when they leave service.ConclusionsJEs do not have worse mental health than SEs, but there is uncertainty in relation to alcohol misuse, MSS and self-harm in more recent joiners. Monitoring these concerns is advisable.

scholarly journals Pharmacological or non-pharmacological interventions for treatment of common mental disorders associated with Tuberculosis: A systematic review

2021 ◽  
Vol 18 ◽  
pp. 147997312110039
Author(s):  
Saeed Farooq ◽  
Jessica Tunmore ◽  
Rifat Comber
Keyword(s):  
Mental Health ◽  
Systematic Review ◽  
Mental Disorders ◽  
Health Outcomes ◽  
Common Mental Disorders ◽  
Local Population ◽  
Psychosocial Interventions ◽  
Explanatory Models ◽  
Mental Health Outcomes ◽  
Pharmacological Interventions

We aimed to review the literature on interventions for treating Common Mental Disorders (CMD) in people with Tuberculosis (TB). We followed PRISMA guidelines and the protocol was registered at PROSPERO. The electronic databases (PsycInfo, CINAHL, Medline, Google Scholar, Embase) were searched from 1982 to 2020. 349 relevant records were screened, with 26 examined at full text. 13 studies were included totalling 4326 participants. A meta-analysis was not possible due to nature of data, thus descriptive synthesis was conducted. Eleven studies evaluated psychosocial interventions, which significantly improved adherence or cure rates from TB, anxiety and depression. The elements of effective psychosocial interventions included; combating stigma, socioeconomic disadvantage, managing associated guilt and fear of contagion, and explanatory models of illness in local population. Two articles evaluated pharmacological interventions (antidepressants and Vitamin D). This is the first systematic review of interventions to treat CMD in TB. The studies were mostly low quality and mental health outcomes were not adequately described. However, this review suggests that it is feasible to develop and test interventions for improving mental health outcomes and enhancing treatment adherence in TB.

scholarly journals 'Protection or punishment?' The implications of detention on the mental health and well-being of migrants, a review of the literature.

2020 ◽  
Author(s):  
Edward Stagg
Keyword(s):  
Mental Health ◽  
Health Outcomes ◽  
Asylum Seekers ◽  
Poor Mental Health ◽  
Mental Health Outcomes ◽  
Narrative Synthesis ◽  
Immigration Detention ◽  
The World ◽  
The Uk ◽  
The Impact

Background: The number of individuals forced to leave their home and seek asylum in other countries has risen alongside political instability, conflict and persecution in many parts of the world. These individuals are therefore extremely vulnerable. Many asylum-seekers have witnessed and experienced traumatic events that have contributed to mental illness. Detention is often used to incarcerate asylum-seekers who are waiting for asylum decisions to be made, however many are held in inadequate conditions for long periods of time. With governments using immigration detention increasingly more often, there are serious questions surrounding the impact this has on the mental health of detainees.Methods: A systematic review was undertaken using a comprehensive search strategy across six databases. Both qualitative and quantitative studies were included in the review providing that the mental health implications of immigration detention were explored or measured. Grey literature was also searched. The quality of the included studies were appraised and a narrative synthesis conducted in order to establish the main findings of the review. The results of the narrative synthesis were included in a conceptual model that explains how detention works to influence mental health. Results: 22 studies were included in the review. Six themes were identified from analysis of study findings from around the world. Five of those themes also occurred within studies conducted within the UK. In both the UK and globally: detention was associated with poor and deteriorating mental health outcomes; specific conditions inside detention centres were found to contribute to poor mental health; longer durations spent in detention were associated with poorer mental health outcomes; several negative behavioural and emotional responses to the detention experience were observed – particularly in children; the trauma of detention and mental health difficulties developed while in detention remained with individuals after release. In addition to these five themes, a higher number of relocations between detention centres contributed to greater mental distress among detainees outside the UK.Conclusions: This review provides evidence to suggest that an association exists between immigration detention and poor mental health outcomes and that many of the mediators of this relationship are universal. The findings of this paper have several implications for further research and policy. The UK must end indefinite detention and move towards alternative solutions for dealing with asylum-seekers. Detention should only be used as a last resort. Vulnerable individuals, such as children and individuals with existing mental health issues should never be detained. Finally, greater care should be taken to ensure that families with young children are not separated from one-another. Due to the implications of the findings included in this review, it is vital that scientific research of this type is allowed to continue. Future research must evaluate the feasibility and suitability of alternative policies to detention.

scholarly journals Mental Health of Keyworkers in the UK during the COVID-19 Pandemic: a Cross-sectional Analysis of a Community Cohort

2020 ◽  
Author(s):  
Kieran Ayling ◽  
Ru Jia ◽  
Trudie Chalder ◽  
Adam Massey ◽  
Elizabeth Broadbent ◽  
...  
Keyword(s):  
Mental Health ◽  
Health Outcomes ◽  
Psychological Factors ◽  
Health Impact ◽  
Mental Health Outcomes ◽  
Cross Sectional ◽  
Cross Sectional Analysis ◽  
Health And Social Care ◽  
The Uk ◽  
Sectional Analysis

AbstractObjectivesPrevious pandemics have resulted in high levels of psychological morbidity among frontline workers. Here we report on the early mental health impact of the COVID-19 pandemic on keyworkers in the UK, as assessed during the first six weeks of nationwide social distancing measures being introduced. Comparisons are made with non-keyworkers, and psychological factors that may be protective to keyworkers’ mental health are explored.DesignCross-sectional analysis of a community cohort study.MethodsDuring April 2020, keyworkers (n=1559) and non-keyworkers (n=1436) completed online measures of depression, anxiety, and stress levels as well as explanatory demographic and psychological factors hypothesised to be related to these mental health outcomes.ResultsKeyworkers reported significantly higher depression, anxiety, and stress than pre-pandemic population norms. Compared to non-keyworkers, keyworkers were more likely to worry about COVID-19 and perceived they were at higher risk from the virus. This was particularly evident for health and social care keyworkers. Younger keyworkers and those in a clinically increased risk group were more likely to report poorer mental health. Lower positive mood, greater loneliness and worrying more about COVID-19 were all associated with poorer mental health outcomes amongst keyworkers.ConclusionsThe mental health impact of the COVID-19 pandemic on keyworkers in the UK has been substantial. Worry about COVID-19 and perceived risk from COVID-19 in keyworkers are understandable given potential increased exposure to the virus. Younger and clinically vulnerable keyworkers may benefit most from any interventions that seek to mitigate the negative mental health impacts of the pandemic.

scholarly journals Impact of COVID-19 and other pandemics and epidemics on people with pre-existing mental disorders: a systematic review protocol and suggestions for clinical care

BMJ Open ◽  
2020 ◽  
Vol 10 (9) ◽  
pp. e040229
Author(s):  
Anjali Sergeant ◽  
Emma Alaine van Reekum ◽  
Nitika Sanger ◽  
Alexander Dufort ◽  
Tea Rosic ◽  
...  
Keyword(s):  
Mental Health ◽  
Systematic Review ◽  
Mental Disorders ◽  
Health Outcomes ◽  
Clinical Care ◽  
Health Resources ◽  
Healthcare Services ◽  
Mental Health Outcomes ◽  
Meta Analyses ◽  
The Impact

IntroductionThe current COVID-19 pandemic has resulted in high rates of infection and death, as well as widespread social disruption and a reduction in access to healthcare services and support. There is growing concern over how the pandemic, as well as measures put in place to curb the pandemic, will impact people with mental disorders. We aim to study the effect of pandemics and epidemics on mental health outcomes for people with premorbid mental disorders.Methods and analysisWith our predefined search strategy, we will search five databases for studies reporting on mental health outcomes in people with pre-existing mental disorders during pandemic and epidemic settings. Search dates are planned as follows: 5 May 2020 and 23 July 2020. The following databases will be searched: MEDLINE/PubMed, CINAHL, PsycINFO, MedRxiv and EMBASE. Data will be screened and extracted in duplicate by two independent reviewers. Studies involving non-clinical populations or patients diagnosed with a mental disorder during a pandemic/epidemic will be excluded. We will include data collected from all pandemics and epidemics throughout history, including the present COVID-19 pandemic. If possible, study findings will be combined in meta-analyses, and subgroup analyses will be performed. We hope that this review will shed light on the impact of pandemics and epidemics on those with pre-existing mental disorders. Knowledge generated may inform future intervention studies as well as healthcare policies. Given the potential implications of the current pandemic measures (ie, disruption of healthcare services) on mental health, we will also compile a list of existing mental health resources.Ethics and disseminationNo ethical approval is required for this protocol and proposed systematic review as we will only use data from previously published papers that have themselves received ethics clearance and used proper informed consent procedures.Systematic review registrationPROSPERO registration number: CRD42020179611.

scholarly journals Longitudinal changes in home confinement and mental health implications: A 17-month follow-up study in England during the COVID-19 pandemic

2021 ◽  
Author(s):  
Feifei Bu ◽  
Andrew Steptoe ◽  
Daisy Fancourt
Keyword(s):  
Mental Health ◽  
Health Outcomes ◽  
Social Study ◽  
Health Impact ◽  
Mental Health Outcomes ◽  
Longitudinal Patterns ◽  
Containment Policy ◽  
The Uk ◽  
High Level

AbstractBackgroundThe COVID-19 pandemic has brought about significant behavioural changes, one of which is increased time spent at home. Although official lockdowns were typically short-term and allowed people to leave their homes for exercise and essential activities, some individuals did not leave their home for prolonged periods due to a range of factors including clinical vulnerability. This study aimed to explore longitudinal patterns of such ‘home confinement’ across different stages of the COVID-19 pandemic in the UK, and its associated predictors and mental health outcomes.MethodsData were from the UCL COVID -19 Social Study. The analytical sample consisted of 25,390 adults in England who were followed up for 17 months from March 2020 to July 2021. Data were analysed using growth mixture models.ResultsOur analyses identified three classes of growth trajectories, including one class showing a high level of persistent home confinement (24.8%), one changing class with clear alignment with national containment policy/advice (32.0%), and one class with a persistently low level of confinement (43.1%). A range of factors were found to be associated the class membership of home confinement trajectories, such as age, gender, income, employment status, social relationships and health. The class with a high level of confinement had the highest number of depressive and anxiety symptoms at the end of the follow-up independent of potential confounders.ConclusionsThere was substantial heterogeneity in longitudinal patterns of home confinement during the COVID-19 pandemic. However, a striking proportion of our sample maintained a high level of home confinement over the course of 17 months, even during periods when containment measures were eased or removed and when infection rates were low. They also had the worst mental health outcomes. This group warrants special attention in addressing the mental health impact of the COVID-19 pandemic.

scholarly journals The mental health impact of COVID-19 and pandemic related stressors among adults in the UK

2020 ◽  
Author(s):  
Tarani Chandola ◽  
Meena Kumari ◽  
Cara L Booker ◽  
Michaela J Benzeval
Keyword(s):  
Mental Health ◽  
Mental Disorders ◽  
Common Mental Disorders ◽  
Adult Population ◽  
Well Being ◽  
Health Impact ◽  
Psychological Well Being ◽  
Wide Range ◽  
The Difference ◽  
The Uk

Background: The coronavirus pandemic has resulted in a wide range of social and economic changes that could, in turn, have affected the mental health of the UK adult population. Previous research has not been able to measure the broad range of potential stressors, nor examine whether recent changes in those stressors have positively or negatively impacted on common mental disorders. Furthermore, it is unclear whether the stressful impact of the lockdown on mental health has accumulated over time or whether people have adapted to the new conditions of lockdown. This study examines whether there was an increase in the prevalence and incidence of Common Mental Disorders (CMD) in the UK adult population during the first few months of lockdown related to the coronavirus pandemic and whether changes in CMD were associated with an increase in stressors related to lockdown and the pandemic. Methods: Longitudinal data from the UK Household Longitudinal Study (wave 9: 2017-2019 and waves 1 and 2 of the Coronavirus survey in April and May 2020 respectively), a representative sample of UK population, were analysed. Common mental disorders (CMD) were measured using the GHQ-12 (cut off >2) at all waves. The difference in the GHQ-12 (using Likert scores) between waves measured changes in psychological well-being. The incidence of CMD and changes in psychological well-being were analysed in relation to pandemic specific stressors and changes in economic, financial, household and psychosocial stressors. Findings: Around 30% of UKHLS adults without CMD in 2017/9 had a CMD in April 2020. However from April to May 2020, the incidence reduced considerably to below 13%. Much of the increase in incident CMD between April and May was associated with an increase in feelings of loneliness, but some of this increase was also associated with increasing domestic work demands (arising out of childcare and home-schooling), working from home, and the receipt of care from outside the home. The reduction in the incidence of many of these stressors in May (compared to April) coincided with a reduction in the incidence of CMD in May. Conclusion: The pandemic and resultant lockdown were associated with an increase in the incidence of CMD in the UK adult population initially in April 2020. These changes were associated with increases in feelings of loneliness and stressors related to work and domestic life and receipt of care. There was some evidence of adaptation to many of these stressors over the lockdown period by May 2020. However, if levels of unemployment and redundancy increase in the near future, the implications for the mental health of the population need careful thought and monitoring.

scholarly journals The impact of sitting time and physical activity on mental health during COVID-19 lockdown

2021 ◽  
Author(s):  
Matthew Pears ◽  
Susanna Kola-Palmer ◽  
Liane Beretta De Azevedo
Keyword(s):  
Mental Health ◽  
Physical Activity ◽  
Health Outcomes ◽  
Online Survey ◽  
Depression Score ◽  
Sitting Time ◽  
Multiple Stepwise Regression Analysis ◽  
Previous Diagnosis ◽  
The Uk ◽  
The Impact

Abstract Objective The primary aim of this study was to investigate the association between physical activity (PA) and sitting time on adults’ mental health (i.e., depression, anxiety and wellbeing) and the influence of mediators and confounders. Methods An online survey was disseminated in the UK between May and June 2020. A total of 284 participants (33.5 ± 12.4 years) self-reported their PA, sitting time and mental health through validated questionnaires. Results Multiple stepwise regression analysis revealed that being of younger age, female, on a lower income, with one or more comorbid health conditions, with a previous diagnosis of mood disorder and increased sitting time independently correlated with higher depression scores (F (13,219) = 12.31, p < 0.001), and explained 42% of the variance. Similar results were found for wellbeing where socio-demographic, health outcomes and sitting time influenced the subjective wellbeing (F (14,218) = 5.77, p < 0.001, 27% variance), although only socio-demographic and health outcomes contributed to the variation in anxiety score (F (13,219) = 7.84, p < 0.001, 32% variance). PA did not explain variation when sitting time was taken into account in any of the models. Combined analysis revealed that participants with lower sedentary time (< 8 h) and with both low or moderate and high PA presented a significantly lower depression score [low PA: (B = −2.7, 95% CI −4.88, −0.52); moderate and high PA (B = −2.7, −4.88, −0.52)]. Conclusion Sitting time was strongly associated with adverse mental health during COVID-19 lockdown and should be considered in future public health recommendations.

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