Mental Health Diagnoses Among Iraq & Afghanistan Veterans From 2002 to 2008

Trends and Risk Factors for Mental Health Diagnoses Among Iraq and Afghanistan Veterans Using Department of Veterans Affairs Health Care, 2002-2008. 07/20/09. Mental health diagnoses increased substantially after the start of the Iraq War among specific subgroups of returned veterans entering VA health care. Early targeted interventions may prevent chronic mental illness. American Journal of Public Health via PubMed

VAOIG Review of Vet Center's Operational Procedures

Healthcare Inspection Readjustment Counseling Service Vet Center Report 07/20/09. The purpose of this review was to gather information on the operational procedures of Vet Centers. The Readjustment Counseling Service (RCS) manages the Vet Centers and the provision of readjustment counseling. RCS has its own organizational structure, manages its own resources, and evaluates its own program. We noted several opportunities to strengthen the Vet Centers’ effectiveness, oversight, and continuous improvement. To improve operations, we recommended that: (1) Vet Center counselors appropriately document in RCS client case files and that corrective action is taken when documentation problems are identified, (2) all Vet Centers have an External Clinical Consultant, (3) each Vet Center has a seat and participates on the support facility’s Mental Health Council, and (4) RCS comply with their existing policies or revise their policies to be consistent with present practice. VAOIG

DoD and VA Cooperate on TBI Research

Defense, Veteran Affairs Work on Brain Injuries 07/20/09. More than half of U.S. servicemembers seriously injured in Iraq or Afghanistan and admitted to Walter Reed Army Medical Center here suffer from traumatic brain injury, according to Defense Veterans Brain Injury Center officials. “The most common injury that we see is, of course, traumatic brain injury,” said Dr. Lucille Beck, chief consultant for rehabilitation services for the Veterans Affairs Department, in a July 16 “Dot Mil Docs” interview on Pentagon Web Radio. “We have statistics from the Army and the Defense Veterans Brain Injury Center, and they are reporting about 52 percent of patients who are exposed to blast injuries and are admitted to Walter Reed Army Medical Center have a brain injury.” DefenseLink

Virtual Reality Treatment for PTSD

Virtual Reality Therapy Controlled Study for War Veterans with PTSD. Preliminary Results. 07/19/09. More than 30 years after signing truces, there are still around 20,000 Portuguese war veterans that fill PTSD (Posttraumatic Stress Disorder) diagnose criteria. Despite many of them attending therapy, the outcome is not cheerful. In this way, a research protocol was devised to investigate the opportunity of adopting virtual reality exposure therapy (VRET) to reduce PTSD symptomathology. This protocol consists on a controlled study (VRET vs. traditional psychotherapy vs. waiting list), where in the VRET condition patients will be graded by being exposed to a virtual reality jungle scenario. The activating episodes, that are comprised of three cues (ambush, mortar blasting and waiting for injured rescue), are repeated 3 times each session. The cues' intensity and frequency increase from session to session. Patients are exposed to the VR world through a HMD (Head Mounted Display). This paper reports on the ongoing research where 4 VRET patients that filled CAPS DSM-IV PTSD criteria were assessed at pretreatment and at the middle of treatment (5th session). Results from IES and SCL-90R dimensions showed no statistical significant differences between assessments, with exception to obsession-compulsion dimension of SCL-90R (F(1;3)=21.235; p<.05), indicating a decrease in obsessive thoughts. However, through descriptive analysis, it was observed a reduction in all IES and SCL-90R dimensions, except for hostility and psychoticism of SCL-90R. Studies in Health Technology and Informatics via PubMed

Virtual worlds as a healing modality for returning soldiers and veterans. 07/19/09. Those who have served in recent conflicts face many challenges as they reintegrate into society. In addition to recovering from physical wounds, traumatic brain injury, and post-traumatic stress disorders, many soldiers also face basic psychological issues about who they are and how to find their place in a society that has not shared their experiences. To address these challenges, we have created a space that provides ongoing opportunities for healing activities, personal exploration and social camaraderie in an online virtual world, Second Life. In such worlds, where each avatar is controlled by a live individual, experiences can be unintuitive, uninviting, considered boring, or difficult to control. To counter this, we are implementing autonomous intelligent agent avatars that can be "on duty" 24/7, serving as guides and information repositories, making the space and activities easy to find and even personalized to the visitor's needs. We report the results of usability testing with an in-world veterans' group. Tests comparing soldiers who use this space as part of their reintegration regimen compared to those who do not are being scheduled as part of the Army's Warriors in Transition program. Studies in Health Technology and Informatics via PubMed

Effects of Smoking on HIV Positive Veterans

Impact of cigarette smoking on mortality in HIV-positive and HIV-negative veterans. 07/19/09. It is unknown whether smoking confers similar mortality risk in HIV-positive as in HIV-negative patients. We compared overall mortality stratified by HIV and smoking of 1,034 HIV-positive block-matched to 739 HIV-negative veterans, enrolled 2001-2002 in the Veterans Aging Cohort 5 Site Study. Adjusted incidence rate ratios (IRR) for mortality were calculated using Poisson regression. Mortality was significantly increased in HIV-positive veterans according to both smoking status and pack-years in unadjusted and adjusted analyses (adjusted IRR 2.31, 95% confidence interval [CI] 1.53-3.49 for HIV-positive current smokers and IRR 1.32, 95% CI 0.67-2.61 for HIV-negative current smokers). Comorbid diseases were also significantly increased according to smoking status and pack-years. Current smoking is associated with poor outcomes; even lower levels of exposure appear to be detrimental in HIV-infected veterans. These findings support the need for improvements in smoking cessation and for studies of mechanisms and diseases underlying increased mortality in smokers with HIV. AIDS Education and Prevention via PubMed