title: Recognition and treatment of psychological disorders during military service in the UK armed forces: a study of war pensioners.
abstract: OBJECTIVE
  Little is known about the detection and treatment of psychological disorders arising during military service. We investigated whether personnel who developed disorders while serving in the UK armed forces came to the attention of medical services for these problems, received corresponding diagnoses, and were treated.
  
  
  METHODS
  For this retrospective record-based study 132 veterans in receipt of a war pension for psychological or physical problems received a lifetime diagnostic interview. Those with onsets of PTSD, depression, or alcohol abuse while in service were compared with those who never developed any condition or only developed it after discharge. Their medical records were inspected for contemporaneous contacts, diagnoses, and treatment.
  
  
  RESULTS
  PTSD and depression, but not alcohol abuse, were independently associated with mental health contacts while in service. The median time from PTSD onset to first contact was 1 month. Under half of personnel meeting criteria for these disorders received a corresponding diagnosis, and alcohol abuse was more likely to be recognised in the context of comorbid PTSD. PTSD was as well recognised in earlier as in later years covered by the study. Most personnel with disorders received treatment, and those treated were more likely to be medically downgraded or discharged.
  
  
  CONCLUSIONS
  War pensioners are more likely than not to have had their psychological problems acknowledged and treated while in service. The fact that these problems are still largely present 10 years later raises questions over the continuity of care associated with the transition to civilian life.
authors.affiliation: Clinical, Educational and Health Psychology, University College London, Gower Street, London, WC1E 6BT, UK. c.brewin@ucl.ac.uk
authors.forename: Chris R
authors.initials: CR
authors.lastname: Brewin
authors.forename: Bernice
authors.initials: B
authors.lastname: Andrews
authors.forename: Jennie
authors.initials: J
authors.lastname: Hejdenberg
mesh_terms: D000368:Aged; D019973:Alcohol-Related Disorders / Q000175:diagnosis / Q000523:psychology / Q000628:therapy; D003863:Depression / Q000175:diagnosis / Q000523:psychology / Q000628:therapy; D005260:Female; D006801:Humans; D038801:International Classification of Diseases; D007407:Interviews as Topic; D008297:Male; D008499:Medical Records; D008605:Mental Health Services / Q000706:statistics & numerical data; D008875:Middle Aged; D008889:Military Personnel / Q000523:psychology* / Q000706:statistics & numerical data; D011569:Psychiatric Status Rating Scales; D012189:Retrospective Studies; D013313:Stress Disorders, Post-Traumatic / Q000175:diagnosis* / Q000523:psychology / Q000628:therapy*; D011795:Surveys and Questionnaires; D013637:Tape Recording; D006113:United Kingdom; D014728:Veterans / Q000523:psychology* / Q000706:statistics & numerical data; D014857:Warfare