Page 120 - JSOM Fall 2021

An Ongoing Series

Timeline of Psychological and Physiological Effects
Occurring During Military Deployment on a Medical Team

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Andrew Hall, MD *; Iram Qureshi, MPH ; Ramey L. Wilson, MD, MPH ; Jacob Glaser, MD 4
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ABSTRACT
Background: The negative effects of deployment on military unknown. This study aims to present a complete timeline of a
mental health is a topic of major interest. Predeployment and deployment’s effect on the psychology and physiology within
postdeployment assessments are common, but to date there a single cohort of military personnel. We hypothesized that
has been little to no intradeployment assessment of military psychological and physiological health changes correlate with
members. This study attempts to determine the physiological time for the deployed population.
and psychiatric effects on Servicemembers over the course
of deployment, to provide a baseline data set and to allow
for better prediction, prevention, and intervention on these Methods
negative effects. Methods: A retrospective analysis was per- A retrospective analysis of a deployed team’s intradeployment
formed on physiological and psychiatric data collected on a serial depression screening results and physiological measure-
single deployed medical team between 16 January 2020 and ments taken between January 2020 and July 2020. The study
12 July 2020. Patient health screening questionnaires (PHQ-9) period is the scheduled deployment period of a single surgical
and physiological measurements were completed serially twice team within United States Special Operations Command Af-
weekly on five active-duty military volunteers for the entirety rica (SOCAF). “Deployment” in this study is defined as being
of a scheduled 6-month deployment. Results: Depression in a foreign country in support of military operations.
symptom development followed a linear trend (p = .0149) and
severity followed a quadratic trend (p < .001) over a length of Depression symptoms were measured during the course of the
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a deployment. Weight (p = .435) and pulse (p = .416) were not deployment by serially completing the PHQ-9 questionnaire.
statistically altered. Mean arterial pressure (MAP) had a statis- PHQ-9 is a standardized health questionnaire consisting of
tically significant reduction (p < .001). Conclusion: In this spe- nine questions each with an answer score ranging from 0 to
cific population, there was a linear relationship between time 3 (for a total score range of 0 to 27). The tenth question asks
deployed and depression symptoms and severity. Depression responders to rate the impact of the symptoms. A score of
symptom severity decreases toward the end of deployment but ≤ 4 suggests minimal depression symptoms that do not require
does not return to baseline before deployment’s end. treatment, while a score > 4 is a marker for mild to severe
depression that may require intervention. Physiological mea-
Keywords: mental health; deployment; depression; military; surements included weight, blood pressure, and pulse. Mea-
physiology; blood pressure; weight; pulse surements were done on volunteer members of the team, and
volunteers were able to opt out of any element of the testing
at any time during the study period. Five members of the team
had physiological measurements taken, while only four of the
Introduction
five underwent continuous PHQ-9 screenings throughout the
Military mental health differs from that of the overall pop- entire time period. One of the five with physiological mea-
ulation and is an area of intensive study. Suicide remains an surements did not have their weight measured. Measurements
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ongoing issue that seems to remain unsolved. Military mental were done twice weekly between 1000 hours and 1700 hours
health research predominantly investigates veterans and their (between 10 a.m. and 5 p.m. local time). The measurements
families before and after, but not during, deployment. Ques- started the day the volunteers assumed their deployed duties
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tions remain unanswered about the relationship between the until the end of the deployment. The location was a noncom-
stress of deployment and psychological health. The physio- bat zone. All volunteers were active-duty medical profession-
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logical changes associated with deployment are also largely als. No medical histories were taken to maintain anonymity,
*Correspondence to andrew.b.hall14.mil@mail.mil
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1 Lt Col Andrew Hall is a surgeon affiliated with the 96 Medical Group, Department of Surgery, Eglin Air Force Base, FL. CDR Jacob Glaser is a
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physician and Iram Qureshi is a biostatistician affiliated with Naval Medical Research Unit, San Antonio, TX COL Ramey Wilson is a physician
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affiliated with the Department of Medicine at the Uniformed Services University of the Health Sciences, Bethesda, MD.
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