THE SCREENING TEST FOR COMMON MENTAL DISORDERS IN THE MILITARY

THE SCREENING TEST FOR COMMON MENTAL DISORDERS IN THE MILITARY Colonel Bui Quang Huy1, Colonel Cao Tien Duc1, Lieutenant Nguyen Trong Dao1, Sublieutenant Pham Thi Thu2 (Psychiatric department, Military Hospital 103) (15th resident physician class, Military medical university) BACKGROUND • There are many mental soldiers in the military • Common mental disorders: depression, bipolar disorder and schizophrenia • In Psychiatric department of Military Hospital 103, many conscripts were hospitalized suffering from mental disorders before enlistment because these diseases can’t be detected at examination for military service • Causes: the lack of psychiatrist in the military • It is necessary to have a rapid test in order to eliminate early psychiatric patients out of the military Furthermore, the test must be as easy as possible to use for the general doctors • Object: To develop a sreening test for common mental disorders in the military •In the world and Vietnam: using Beck depression scale, Zung anxiety scale, rating scale for depression, anxiety Hamilton These scales just intend to determine the degree of the diseases rather than be a diagnotic tool •Diagnostic and Statistical Manual of Mental Disorders, 5th ed (DSM-5) •International Classification of Diseases, 10th ed (ICD10) have many specialized terms •In the world and Vietnam: using Beck depression scale, Zung anxiety scale, rating scale for depression, anxiety Hamilton These tool just supports intended to determine the degree of the disease rather than a diagnostic tool •Diagnostic and Statistical Manual of Mental Disorders, 5th ed (DSM-5) •International Classification of Diseases, 10th ed (ICD10) uses many specialized terms relatively confusing for the general doctors as bizarre delusions, grandiose delusion, flight of idea Decreased need for sleep ( they just sleep 1-2 Present hours per day without fatigue) Not present Elevated mood (his face express the excitement and excessive happiness) Present Not present Inflated self-esteem (believe that he have many Present talents) Not present More talkative than usual or pressure to keep talking (he say fast, say constantly throughout the day, talking about all subjects) Present Not present Exessive happiness (his facial expression is very happy, joyful attitude, laughing chatter He sings, reads Present poetry, acts drama passionately without knowing whether Not present people around him want to enjoy it) Flight of idea (his thoughts overlap like we monitored simultaneously or television programs, Present Not present moving abruptly from one topic to another) Distractibility (inability to concentrate attention, Present not focus on a certain job if there is small external stimuli) Not present Increase in goal-directed activity (shopping very Present much, beyond their ability to pay, more sexual relations) Delusion • Persecutory delusion • Referential delusion • Delusion of control • Grandiose delusion • Bizarre delusions Hallucination • Comment auditory halucination • Command hallucination • Auditory hallucination • Visual hallucination •Tactile hallucination Delusion • Persecutory delusion • Referential delusion • Delusion of control • Grandiose delusion • Bizarre delusions Hallucination • Comment auditory halucination • Command hallucination • Auditory hallucination • Visual hallucination •Tactile hallucination believe that they are abused, tortured, poisoned, would be killed by a person or a certain force Delusion • Persecutory delusion • Referential delusion • Delusion of control • Grandiose delusion • Bizarre delusions Hallucination • Comment auditory halucination • Command hallucination • Auditory hallucination • Visual hallucination •Tactile hallucination believing that some books, essays, songs or some other external information refer them with the special forms Delusion • Persecutory delusion • Referential delusion • Delusion of control • Grandiose delusion • Bizarre delusions Hallucination • Comment auditory halucination • Command hallucination • Auditory hallucination • Visual hallucination •Tactile hallucination believe that his actions are being acted on or manipulated by some outside force THE SREENING TEST FOR DEPRESSIVE EPISODE • Sleep disturbances • Depressed mood • Diminished interest or pleasure in almost activities • Decreased appetite, weight loss • Psychomotor change • Dereased energy • Feelings of worthlessness or inapprociate guilt • Diminished ability to think or concentrate or indecisiveness • Thoughts of death or have suicidal behaviors THE SREENING TEST FOR DEPRESSIVE EPISODE • Sleep disturbances • Depressed mood • Diminished interest or pleasure in almost activities • Decreased appetite, weight loss • Psychomotor change • Dereased energy • Feelings of worthlessness or inapprociate guilt • Diminished ability to think or concentrate or indecisiveness • Thoughts of death or have suicidal behaviors At least one of the following symtomps has been present: difficulty initialing sleep, difficlut maintaining sleep, waking up too early or sleep more than 10 hours every day THE SREENING TEST FOR DEPRESSIVE EPISODE • Sleep disturbances • Depressed mood • Diminished interest or pleasure in almost activities • Decreased appetite, weight loss • Psychomotor change • Dereased energy • Feelings of worthlessness or inapprociate guilt • Diminished ability to think or concentrate or indecisiveness • Thoughts of death or have suicidal behaviors The patient's facial expression very monotonous, always sad, wrinkles reduce, even lose wrinkles THE SREENING TEST FOR DEPRESSIVE EPISODE • Sleep disturbances • Depressed mood • Diminished interest or pleasure in almost activities • Decreased appetite, weight loss • Psychomotor change • Dereased energy • Feelings of worthlessness or inapprociate guilt • Diminished ability to think or concentrate or indecisiveness • Thoughts of death or have suicidal behaviors Individual may report not feeling any enjoyment in activities that were prevously considered pleasurable THE SREENING TEST FOR DEPRESSIVE EPISODE • Sleep disturbances • Depressed mood • Diminished interest or pleasure in almost activities • Decreased appetite, weight loss • Psychomotor change • Dereased energy • Feelings of worthlessness or inapprociate guilt • Diminished ability to think or concentrate or indecisiveness • Thoughts of death or have suicidal behaviors Loss of appetite, eating less, forced to eat, lost more than 1kg in a month when not dieting THE SREENING TEST FOR DEPRESSIVE EPISODE • Sleep disturbances • Depressed mood • Diminished interest or pleasure in almost activities • Decreased appetite, weight loss • Psychomotor change • Dereased energy • Feelings of worthlessness or inapprociate guilt • Diminished ability to think or concentrate or indecisiveness • Thoughts of death or have suicidal behaviors e.g., pacing, inability to sit still or slowed speech, thinking, and body movement; speech that is dereased in volume, amount and variety of content THE SREENING TEST FOR DEPRESSIVE EPISODE • Sleep disturbances • Depressed mood • Diminished interest or pleasure in almost activities Fatigue or exhaustion, even • Decreased appetite, weight loss a smallest tasks seem to • Psychomotor change require substantial effort • Dereased energy • Feelings of worthlessness or inapprociate guilt • Diminished ability to think or concentrate or indecisiveness • Thoughts of death or have suicidal behaviors THE SREENING TEST FOR DEPRESSIVE EPISODE • Sleep disturbances • Depressed mood • Diminished interest or pleasure in almost activities • Decreased appetite, weight loss • Psychomotor change • Dereased energy • Feelings of worthlessness or inapprociate guilt • Diminished ability to think or concentrate or indecisiveness • Thoughts of death or have suicidal behaviors believe that he was worthless, becoming a burden to family, institutions and society THE SREENING TEST FOR DEPRESSIVE EPISODE • Sleep disturbances • Depressed mood • Diminished interest or pleasure in almost activities • Decreased appetite, weight loss • Psychomotor change • Dereased energy • Feelings of worthlessness or inapprociate guilt • Diminished ability to think or concentrate or indecisiveness • Thoughts of death or have suicidal behaviors Unable to read a short article, unable to listen all the songs they used to love, unable to watch a television program that they previously still interested THE SREENING TEST FOR DEPRESSIVE EPISODE • Sleep disturbances • Depressed mood • Diminished interest or pleasure in almost activities • Decreased appetite, weight loss • Psychomotor change • Dereased energy • Feelings of worthlessness or inapprociate guilt • Diminished ability to think or concentrate or indecisiveness • Thoughts of death or have suicidal behaviors May range from not to awaken in the morning or a belief that others would be better if the individual were dead, to transient but recurrent thoughts of commitng suicide, to a specific suicide plan •Each item is scored independently based on a twopoint, ratio scale •A rating of and indicates that the symptom is present and not present in the soldier, respectively proceeding through the three sections compiling a total, composite score based upon the summation of each item Manic episode Depressive episode Psychosis episode 0-8 0-9 0-10 DEPRESSIVE EPISODE Negative ≤2 Doubl 3-4 Possitive ≥5 MANIC EPISODE Negative ≤2 Doubl Possitive ≥4 PSYCHOSIS EPISODE Negative Possitive ≥1 CONCLUSION • Possible application: can be used from the regimental hospital or more The general doctor needn’t be trained more in psychiatry still being able to apply to diagnose mental disorders easily • The test has been applied in the whole army to mental health screening • Limitation: with the aims to exclude mental soldier from the military, the test is to determine whether or not the expression of mental disorders • Therefore, there should be further studies to develop the questionnaire, which can help confirm the diagnosis of mental disorders THANK YOU FOR YOUR ATTENTION !!!