Stress, Sleep and Depressive Symptoms in Active Duty Military Personnel

Assessment of psychiatrists' preparedness in managing disaster-related psychiatric disorders: a survey in Taiwan from post-graduate medical education perspective

Background

Disaster-related psychiatric disorders (DRPD) present a significant challenge to mental health professionals, yet there is a notable lack of emphasis on the preparedness of psychiatrists in managing these conditions within post-graduate medical education.

Methods

This study utilized a questionnaire to collect data from psychiatrists, focusing on their prior involvement in managing DRPD, perceived competence, medication preferences, and factors influencing their experiences in handling such disorders. Analysis included distribution and ranking of variables, alongside cross-analysis examining associations between demographic factors (age, gender, hospital levels, years of practice, board certification) and treatment experiences, as well as readiness for in-hospital or outside-hospital mobilization in DRPD management.

Results

One hundred and three Taiwanese psychiatrists participated in the study, with the majority reporting involvement in managing DRPD (71.8%), particularly in post-traumatic stress disorder (PTSD) and depression. Antidepressants, specifically serotonin selective reuptake inhibitors, were commonly preferred for DRPD treatment, including PTSD and depression. Psychiatrists aged over 40, with more than 10 years of practice, and hold the board-certified status, showed greater experiences for outside- or inside- the hospital mobilization in DRPD management.

Conclusion

Findings suggest that within post-graduate medical education, Taiwanese psychiatrists demonstrate significant experience, willingness, and capacity to effectively manage DRPD. However, there is a need to integrate comprehensive training on disaster psychiatry into post-graduate psychiatric education programs to further enhance preparedness and optimize outcomes in managing these challenging conditions.

Hypoglossal Nerve Stimulator in the Active Duty Population: Military Readiness and Satisfaction

INTRODUCTION

Because inadequate sleep impairs mission performance, the U.S. Army regards sleep as a core pillar of soldier readiness. There is an increasing incidence of obstructive sleep apnea (OSA) among active duty (AD) service members, which is a disqualifying condition for initial enlistment. Moreover, a new diagnosis of OSA in the AD population often prompts a medical evaluation board, and if symptomatic OSA proves refractory to treatment, this may result in medical retirement. Hypoglossal nerve stimulator implantation (HNSI) is a newer implantable treatment option, which requires minimal ancillary equipment to function and may provide a useful treatment modality to support AD service members while maintaining readiness in appropriate candidates. Because of a perception among AD service members that HNSI results in mandatory medical discharge, we aimed to evaluate the impact of HNSI on military career progression, maintenance of deployment readiness, and patient satisfaction.

METHODS

The Department of Research Programs at the Walter Reed National Military Medical Center provided institutional review board approval for this project. This is a retrospective, observational study and telephonic survey of AD HNSI recipients. Military service information, demographics, surgical data, and postoperative sleep study results were collected from each patient.Additional survey questions assessed each service member's experience with the device.

RESULTS

Fifteen AD service members who underwent HNSI between 2016 and 2021 were identified. Thirteen subjects completed the survey. The mean age was 44.8 years (range 33-61), and all were men. Six subjects (46%) were officers. All subjects maintained AD status following HNSI yielding 14.5 person-years of continued AD service with the implant. One subject underwent formal assessment for medical retention. One subject transferred from a combat role to a support role. Six subjects have since voluntarily separated from AD service following HNSI. These subjects spent an average of 360 (37-1,039) days on AD service. Seven subjects currently remain on AD and have served for an average of 441 (243-882) days. Two subjects deployed following HNSI. Two subjects felt that HSNI negatively affected their career. Ten subjects would recommend HSNI to other AD personnel. Following HNSI, of the eight subjects with postoperative sleep study data, five achieved surgical success defined as >50% reduction of apnea-hypopnea index and absolute apnea-hypopnea index value of <20.

CONCLUSIONS

Hypoglossal nerve stimulator implantation for AD service members offers an effective treatment modality for OSA, which generally allows for the ability to maintain AD status, however: The impact on deployment readiness should be seriously considered and tailored to each service member based on their unique duties before implantation. Seventy-seven percent of HNSI patients would recommend it to other AD service members suffering from OSA.

Sleep quality analysis of Chinese medical civilians in the Subtropics during different stages of deployment.. [DOI: 10.21203/rs.3.rs-2306219/v1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0]

Background: Inadequate sleep and poor sleep quality have been linked to higher incidences of major industrial and workplace accidents. They also have been associated with poorer health outcomes, such as increased risks of obesity, diabetes, cardiovascular disease, neurogenerative diseases, and poor mental health. Therefore, it is important to ensure adequate sleep and good sleep quality to promote the physical and mental wellbeing of individuals. The aim of this study was to analyze the sleep quality of medical civilians participating in a medical emergency rescue exercise, which involved travelling long distances on a train. Methods: We used the Pittsburgh Sleep Quality Index (PSQI) to measure the sleep duration and sleep quality during four different phases of the exercise, namely the training phase (T1), travel phase (T2), official task phase (T3), and quarantine phase (T4). Results: The mean sleep durations during each phase were 6.678 h (T1), 6.64 h (T2), 6.41 h (T3), and 7.06 h (T4), and the mean PSQI score of the sleep quality across all four phases was 4.43. The highest proportion of sleep disturbance occurred during the travel phase (c2=477; p<0.001). The nonmedical team members had a longer sleep duration and a better sleep quality compared to those of the medical team members (p<0.05). Conclusion: Our study demonstrated that medical civilians experience a shorter sleep duration and a poorer sleep quality during deployment. Interventions such as lowering acute stress levels and workload, promoting good sleep hygiene and attitudes towards sleep, and improving the sleep environment may help to improve the overall sleep quality of medical team members.

Prevalence of Helicobacter pylori Infection in Military Personnel from Northeast China: A Cross-Sectional Study

PURPOSE

Helicobacter pylori infection is an important cause of peptic ulcer disease and gastric cancer. Current knowledge regarding epidemiology of H. pylori infection in military personnel has insufficiently been updated. This cross-sectional study aimed to estimate the prevalence of H. pylori infection in military personnel and to compare the prevalences in military and civilian groups.

PATIENTS AND METHODS

We retrospectively enrolled the subjects who underwent ¹⁴C-urea breath tests at the Department of Gastroenterology of the General Hospital of Northern Theater Command between January 2017 and July 2020. Subjects were divided into military and civilian groups. H. pylori infection and major endoscopic findings were reviewed.

RESULTS

Overall, 23,496 subjects were eligible, including 2282 subjects in the military group and 21,214 subjects in the civilian group. In the overall analysis, the prevalence of H. pylori infection was not significantly different between military and civilian groups (33.9% versus 34.4%, P=0.592). In the population aged 17-25 years, the prevalence of H. pylori infection was significantly higher in the military group than in the civilian group (35.6% versus 25.9%, P=0.001). Both ¹⁴C-UBT and endoscopy were performed in 547 inpatients, including 83 military inpatients and 464 civilian inpatients. There was a significantly higher prevalence of H. pylori in inpatients with peptic ulcer and/or gastric cancer than in those without (65.5% versus 41.4%, P=0.001).

CONCLUSION

Among the adolescent population, H. pylori infection may be more common in military personnel as compared to the civilians. Well-designed prospective studies should be required to validate such a high prevalence and to explain its potential causes.

Effect of yoga on vigilance, self rated sleep and state anxiety in Border Security Force personnel in India

BACKGROUND

Military occupations require heightened vigilance with resultant sleep disturbances, increased anxiety and reduced vigilance.

OBJECTIVE

To compare yoga with physical training to reduce insomnia, anxiety and increase vigilance in security personnel.

METHODS

One hundred and twelve Border Security Force personnel (BSF group, males; mean age±SD = 30.4±7.4 years) were compared with 112 personnel of a private security firm (SIS group). The BSF group received yoga for nine days and the SIS group received physical training for the same period. Assessments were at baseline and after 9 days, with the digit vigilance test (DVT), Spielberger's STAI-S, and a sleep rating questionnaire.

RESULTS

(1) Between groups: (i) at baseline the BSF group had higher vigilance and more daytime naps compared to the SIS group and (ii) after nine days the SIS group had higher state anxiety compared to the BSF group (ANOVA, Bonferroni adjusted post-hoc comparisons; SPSS Version 24.0) (2) In post-pre intervention comparisons (i) the BSF group increased vigilance and decreased state anxiety after yoga, with improved sleep, while (ii) the SIS group showed increased vigilance after physical training.

CONCLUSION

Yoga may improve sleep, reduce anxiety while increasing vigilance in occupations requiring vigilance.