Health

Soldiers’ mental health after an acute injury- A concern

As everyone is aware by this time that mental health is really underrated and not considered as important as it should be. Above all, did you consider what a soldier goes through when he/she returns from a war? Sometimes, they not only get physically hurt but mentally traumatized too. For instance, all the bloodshed encounter and watching their fellow soldiers dying in front of their eyes, not returning home with them.

For some veterans, it leaves a pretty deep scar due to which most of them suffer from Post-Traumatic Stress Disorder (PTSD). They relive the whole incident again and again. Other than this, there is a feeling of hopelessness and helplessness which leaves the person shattered emotionally.

According to recent studies, it is discovered that the soldiers who have suffered from Traumatic Brain Injury (TBI), mild or severe, are more prone to experiencing various mental health disorders.

David L.Chin and John E. Zeber from University of Massachusetts, Amherst; US soldiers, who got injured while serving in Iran and Afghanistan from February 2002 to February 2011 were evaluated focusing on the relationship between TBI and various mental health illness diagnosis. For the assessment, 4980 members met the criteria. Mostly injured members were from the Army (72%) as per the data from Dept of Defence Trauma Registry) and Marine (25%). Commonly TBI – moderate or severe were 31.6% with more than 78% of these were sustained from an explosion. Seven out of ten patients were diagnosed with mental disorders, at least one, ranging from a moderate increase of anxiety disorder to a large increase in a cognitive disorder. So, the noted increment in mental disorders were associated with Traumatic Brain Injury.

Chin mentioned in a statement that “TBI resulted in an amnestic effect on PTSD – the injuries were so severe that the patients have no memory of the event and that put them at lower risk of having mental health problems.” This data is showed to the contrary.

Researchers had put more emphasis on PTSD and its treatment and less attention towards other mental illnesses. During the World War I, a British Psychologist Charles Samuels Myers coined the term ‘Shell Shock’ describing the types of PTSD which veterans were afflicted with – after the warfare. The way they carry out after attacks and all the bloodshed produced feeling of helplessness in the form of panic attacks, being scared, flight, difficulty sleeping, reasoning, walk or talk. They reported symptoms like headaches, amnesia, dizziness and hypersensitivity to noise. Though, at that time, the term was ill-defined.

This research was designed in contrast to previous researches which examined the impacts after mild TBI and the reports also stated there were no impacts of mild TBI on PTSD or any cognitive outcome measures. Earlier, reports set forth no signs of PTSD after TBI because of impaired consciousness during the trauma, which may have prevented the encoding of traumatic memories necessary for development of PTSD. So, this investigation is in addition with the mild TBI exposures.

The estimation was approximately 3% higher than previous investigation but considerably higher than the previous reports among Afghanistan and Iraq war veterans. Service personnel were diagnosed with at least one mental health disorder which was nearly 70% which turned out to be 28% higher as compared to the previous findings.

The previous studies concludes the insignificant relationship between TBI with schizophrenia and any other psychotic conditions. Also, the research stated that the women are more prone to PTSD, adjustments and mood disorders. These findings are consistent with various studies done before this and systematic review found that women are at a greater risk of suffering from PTSD in comparison to men.

The limitations are that the data of the veterans who were posted into wars but were not injured and the ones who were not positioned – was not obtained. The demographic data for social determinants of health like economics, personnel rank, community or family support, education achieved – which might directly or indirectly – add to mental health risk.

Secondly, the research included the clinical incidents recorded within Military hospitals (DOD) or Tricare only, other health care centers were not included in this.

Finally, investigating a long follow up period of average 4.1 years to diagnose mental illness later may also add on to the potential for effects from non-injury or nonmilitary exposures occurring after getting discharged from their active duties. There were some differences observed in the comparison of demographic groups which couldn’t be examined.

To sum up, this analysis might have some effect on various stakeholders and consideration could be taken by clinicians and health system administrations to look at the opportunities to increase follow ups for longer period of time, timely monitoring of mental health status and educating the soldiers as well. Also, the veterans (who have suffered from war injuries) and their families may be prepared to look for potential sequelae related to their mental health and foresee the health care needs according to the possible symptoms associated with the diagnosis and treatment.

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