title: The presentation of depression in the British Army.
abstract: BACKGROUND
  The British Army is predominately composed of young men, often from disadvantaged backgrounds, in which Depression is a common mental health disorder.
  
  
  OBJECTIVE
  To construct a predictive model detailing the presentation of depression in the army that could be utilised as an educational and clinical guideline for Army clinical personnel.
  
  
  METHODS
  Utilising a Constructivist Grounded Theory, phase 1 consisted of 19 interviews with experienced Army mental health clinicians. Phase 2 was a validation exercise conducted with 3 general practitioners.
  
  
  RESULTS
  Depression in the Army correlates poorly with civilian definitions, and has a unique interpretation.
  
  
  CONCLUSIONS
  Young soldiers presented with symptoms not in the International Classification of Disorders and older soldiers who feared being medically downgraded, sought help outside the Army Medical Services. Women found it easier to seek support, but many were inappropriately labelled as depressed. Implications include a need to address the poor understanding of military stressors; their relationships to depressive symptoms and raise higher awareness of gender imbalances with regard to access and treatment. The results have international implications for other Armed forces, and those employed in Young Men's Mental Health. The results are presented as a simple predictive model and aide memoire that can be utilised as an educational and clinical guideline. There is scope to adapt this model to international civilian healthcare practice.
authors.affiliation: British Army, Royal Centre for Defence Medicine (Research), ICT Building, Birmingham Research Park, Vincent Drive, Edgbaston, Birmingham, B15 2SQ, United Kingdom. Electronic address: alanfinnegan167@hotmail.com.
authors.forename: Alan
authors.initials: A
authors.lastname: Finnegan
authors.forename: Sara
authors.initials: S
authors.lastname: Finnegan
authors.forename: Mike
authors.initials: M
authors.lastname: Thomas
authors.forename: Martin
authors.initials: M
authors.lastname: Deahl
authors.forename: Robin G
authors.initials: RG
authors.lastname: Simpson
authors.forename: Robert
authors.initials: R
authors.lastname: Ashford
mesh_terms: D003866:Depressive Disorder / Q000175:diagnosis* / Q000523:psychology; D005260:Female; D006801:Humans; D008297:Male; D008889:Military Personnel / Q000523:psychology*; D006113:United Kingdom
keywords: British Army; Clinical assessment; Defence; Depression; Mental health; Primary healthcare education; Qualitative research methods