Mental health in spouses of U.S. Gulf War veterans

Criteria and diagnostic scale of the post-combat delayed response (tension) syndrome

OBJECTIVE

War participation risks mental disorders. Ukrainian combatants in Anti-Terrorist Operation/Joint Forces Operation since 2014 receive psychiatric care. Some show unique symptoms, not fitting recognized disorders, termed post-combat delayed response (tension) syndrome. The aim of this study was to establish diagnostic criteria and develop a scale of differential diagnosis of post-combat delayed response (tension) syndrome.

METHODS

This was a clinical retrospective study conducted on the basis of Zaporizhzhia Military Hospital and Zaporizhzhia and State Medical University, Ukraine, in the period from 2015 to 2021. Combatants of Ukraine-members of Anti-Terrorist Operation/Joint Forces Operation were involved in the study. In total, 426 male combatants were surveyed from whom those suffering from post-traumatic stress disorder (n = 24), neurasthenia (n = 35), and post-combat delayed response (tension) syndrome (n = 46) were selected.

RESULTS

The key symptoms of post-combat delayed response (tension) syndrome were selected and ranked in order of their differential diagnostic value. The diagnostic scale for post-combat delayed response (tension) syndrome was developed, which consists of 12 points.

CONCLUSIONS

The received anamnestic information is important for classifying patients at risk of post-combat delayed response (tension) syndrome.

Experiences and views of frontline healthcare workers' family members in the UK during the COVID-19 pandemic: a qualitative study

BACKGROUND

The COVID-19 pandemic has had a well-documented negative impact on the mental health and wellbeing of frontline healthcare workers (HCWs). Whilst no research has to date been carried out to explore the challenges experienced by the families of HCWs, some previous research has been conducted with military families, demonstrating that family members of deployed military personnel may also be affected seriously and negatively.

OBJECTIVES

This study aimed to explore the experiences, views, and mental health impact on frontline HCWs' families during the COVID-19 pandemic in the UK and what support the families of frontline HCWs may need.

METHOD

Close family members and friends of HCWs were interviewed. Transcripts were analysed in line with the principles of reflexive thematic analysis.

RESULTS

We completed fourteen interviews with three siblings, one mother, one friend, and nine spouses of HCWs. Family members were highly motivated to support healthcare workers and felt an intense sense of pride in their work. However, they also experienced increased domestic responsibilities and emotional burden due to anxiety about their loved ones' work. The fact that sacrifices made by family members were not noticed by society, the anxiety they felt about their family's physical health, the impact of hearing about traumatic experiences, and the failure of healthcare organisations to meet the needs of the HCWs all negatively affected the family members.

CONCLUSIONS

We have an ethical responsibility to attend to the experiences and needs of the families of healthcare professionals. This study emphasises the experiences and needs of family members of healthcare professionals, which have hitherto been missing from the literature. Further research is needed to hear from more parents, siblings and friends, partners in same sex relationships, as well as children of HCWs, to explore the variety of family members and supporters' experiences more fully.

HIGHLIGHTS

• COVID19 has impacted families of HCWs as well as workers themselves. They have experienced more anxiety, increased practical burden, significant physical health risks and been exposed vicariously to workers' traumatic experiences. We must ensure HCW families are better supported.

A cohort study of neuropsychological functioning in spouses of U.S. Gulf War veterans

AIMS

Veterans of the 1991 Gulf War reported symptoms in their spouses that mirrored veterans' symptoms following their return from the war, including problems with attention and memory. Neuropsychological functioning in these spouses has not been examined with objective tests. This study sought to determine if these spouses exhibited deficits in neuropsychological functioning.

MAIN METHODS

Spouses of a national cohort of 1991 Gulf War deployed (n = 470) and non-deployed veterans (n = 524) were examined with neuropsychological tests in 1999-2001.

KEY FINDINGS

Neuropsychological tests were factor analyzed yielding five factors: verbal memory, visual memory, attention/working memory, visual organization, and motor speed. Spouses of deployed and nondeployed veterans did not differ on mean factor scores, percentage of impaired factors, or individual test scores. Spouse attention/working memory was related to their having diagnoses of PTSD or anxiety disorders, or self-reported symptoms of current anxiety. Spouse visual memory was related to a diagnosis of current depression. Spouse motor speed was related to their own status of having chronic multisymptom illness (CMI).

SIGNIFICANCE

Spouses of Gulf War deployed and nondeployed veterans demonstrated similar neuropsychological functioning, although spouses with psychiatric diagnoses and symptoms, or CMI demonstrated neuropsychological impairments characteristic of those conditions, suggesting that monitoring spouses for these conditions and impairments may be warranted. This pattern of relative weaknesses mirrors some of the previously reported findings for Gulf War veterans, although the veterans displayed neuropsychological impairments beyond what was accounted for by these conditions.

Associations of warzone veteran mental health with partner mental health and family functioning: Family Foundations Study

INTRODUCTION

Warzone participation is associated with increased risk of stress-related psychopathology, including posttraumatic stress disorder (PTSD) and depression. Prior research suggests that the mental health of spouses of warzone veterans (WZVs) is linked to that of their partners. Additionally, PTSD among WZVs has been associated with marital dysfunction. Less is known about the effects of depression among WZVs on partner mental health and family relationships. We sought in this study to examine associations between WZV PTSD and depression and partner mental health and relationship outcomes.

METHODS

Using a nationally dispersed sample of Iraq and Afghanistan veterans and their married and unmarried intimate partners, 245 dyads completed structured psychiatric interviews and psychometric surveys assessing family functioning and relationship aggression.

RESULTS

Adjusted regression analyses indicated that depression among WZVs was associated with partner depression and anxiety disorders. WZV PTSD and depression were also associated with partner-reported relationship dysfunction, dissatisfaction, and communication issues, and higher rates of intimate partner aggression victimization and perpetration.

CONCLUSIONS

Mental health consequences of war extend beyond WZVs to the mental health of their intimate partners and their relationships with intimate partners.