Simon Wessely

King's College London, Department of Psychological Medicine, Faculty Member

Followers

Following

Co-authors

Public Views

Interests

Uploads

Papers by Simon Wessely

Public information needs after the poisoning of Alexander Litvinenko with polonium-210 in London: cross sectional telephone survey and qualitative analysis

BMJ, 2007

Objectives To identify public perceptions of the risk to health after the poisoning of Alexander ... more Objectives To identify public perceptions of the risk to health after the poisoning of Alexander Litvinenko with polonium-210 ( 210 Po) in London and to assess the impact of public health communications. Design Cross sectional telephone survey and qualitative interviews. Setting London, United Kingdom. Participants 1000 people completed the cross sectional survey and 86 potentially exposed people completed the qualitative interviews. Main outcome measures Perception of risk to personal health after the 210 Po incident. Qualitative interviews were analysed with an emphasis on information needs. Results 11.7% of the survey sample (n=117) perceived their health to be at risk. Aside from personal variables the main predictors of perceived risk to health were believing that the incident was related to terrorism (odds ratio 2.7, 95% confidence interval 1.5 to 4.6) rather than to espionage, that it was targeted at the wider public rather than one person (5.9, 3.2 to 10.9), and that it could affect people who had not been in the contaminated area (3.2, 2.1 to 5.1). Participants in the qualitative interviews were generally satisfied with the information they had received, although they would have preferred more information about their individual risk of exposure, the results of their urine tests, and the health implications of the incident. Conclusions Perceptions of the public that the 210 Po incident in London in 2006 was related to espionage helped to reassure them that the risks to personal health were low. In the event of future incidents it is important to ensure that detailed, comprehensible information about the risks of any exposure is available.

Download

Prevalence of PTSD and other mental disorders in UK service personnel by time since end of deployment: a meta-analysis

BMC Psychiatry, 2016

Background: US studies have shown an increase of posttraumatic stress disorder (PTSD) and depress... more Background: US studies have shown an increase of posttraumatic stress disorder (PTSD) and depression, but not alcohol misuse related to time of assessment since returning from deployment. We assessed if similar trends occur in the UK Armed Forces. Methods: We selected UK studies based on our data base of King's Centre for Military Health Research publications from 2006 until January 2016 with at least one of the following measures: PTSD checklist-civilian version (PCL-C), the General Health Questionnaire (GHQ-12) and the Alcohol Use Disorders Identification Test (AUDIT). The studies included personnel assessed for these outcomes after their most recent deployment. A search in Medline, Psycho-Info and Embase confirmed that no relevant publication was missed. Results: Twenty one thousand, seven hundred and forty-six deployed personnel from nine studies contributed to the meta-analyses by time since end of deployment in the PTSD analysis. The number of studies for period of time varied from two to four studies. The trend by time-category of questionnaire completion since returning from deployment were for PTSD β = 0.0021 (95 % CI −0.00046 to 0.0049, p = 0.12), for psychological distress β = 0.0123 (95 % CI 0.005 to 0.019, p = 0.002) and for alcohol misuse β = 0.0013 (−0.0079 to 0.0105, p = 0.77). Conclusions: There was no evidence that the prevalence of PTSD and alcohol misuse changed according to time since the end of deployment over a three-year period, but there was evidence for an association with increasing psychological distress.

Download

The health of UK civilians deployed to Iraq

European journal of public health, Apr 24, 2016

Modern military operations have incorporated deployed civilians in a variety of roles (e.g. diplo... more Modern military operations have incorporated deployed civilians in a variety of roles (e.g. diplomats, private security staff). Many of these roles expose individuals to potentially dangerous or traumatic events. Evidence has shown that such exposures can cause psychological health problems in military personnel. It is likely that the same would be seen among civilians working in such environments. There is however limited research into the health of civilians deployed to war zones. This study compared health outcomes and related behaviours among UK regular and reserve Army personnel with UK civilian personnel deployed in direct support of the UK military in Iraq. The study sample comprised of 159 Ministry of Defence civilians, 1542 Army regulars and 408 Army reservists, all of whom served in non-combat roles. Data were gathered by questionnaires which asked about deployment experiences, lifestyle factors and health outcomes [i.e. post-traumatic stress disorder (PTSD), general healt...

Download

What explains post-traumatic stress disorder (PTSD) in UK service personnel: deployment or something else?

Psychological medicine, 2013

In previous studies an association between deployment to Iraq or Afghanistan and an overall incre... more In previous studies an association between deployment to Iraq or Afghanistan and an overall increased risk for post-traumatic stress disorder (PTSD) in UK armed forces has not been found. The lack of a deployment effect might be explained by including, in the comparison group, personnel deployed on other operations or who have experienced traumatic stressors unrelated to deployment. The sample comprised 8261 regular UK armed forces personnel who deployed to Iraq, Afghanistan or other operational areas or were not deployed. Participants completed the PTSD CheckList-Civilian Version (PCL-C) and provided information about deployment history, demographic and service factors, serious accidents and childhood experiences. Deployment to Iraq or Afghanistan [odds ratio (OR) 1.2, 95% confidence interval (CI) 0.6-2.2] or elsewhere (OR 1.1, 95% CI 0.6-2.0) was unrelated to PTSD although holding a combat role was associated with PTSD if deployed to Iraq or Afghanistan (OR 2.7, 95% CI 1.9-3.9). C...

Download

Posttraumatic stress disorder post Iraq and Afghanistan: prevalence among military subgroups

Canadian journal of psychiatry. Revue canadienne de psychiatrie, 2014

A large body of research has been produced in recent years investigating posttraumatic stress dis... more A large body of research has been produced in recent years investigating posttraumatic stress disorder (PTSD) among military personnel following deployment to Iraq and Afghanistan, resulting in apparent differences in PTSD prevalence. We compare prevalence estimates for current PTSD between military subgroups, providing insight into how groups may be differentially affected by deployment. Systematic literature searches using the terms PTSD, stress disorder, and acute stress, combined with terms relating to military personnel, identified 49 relevant papers. Studies with a sample size of less than 100 and studies based on data for treatment seeking or injured populations were excluded. Studies were categorized according to theatre of deployment (Iraq or Afghanistan), combat and noncombat deployed samples, sex, enlistment type (regular or reserve and [or] National Guard), and service branch (for example, army, navy, and air force). Meta-analysis was used to assess PTSD prevalence acros...

Download

Aggressive and violent behavior among military personnel deployed to iraq and afghanistan: prevalence and link with deployment and combat exposure

Epidemiologic reviews, 2015

A systematic review and meta-analyses were conducted on studies of the prevalence of aggressive a... more A systematic review and meta-analyses were conducted on studies of the prevalence of aggressive and violent behavior, as well as of violent offenses and convictions, among military personnel following deployment to Iraq and/or Afghanistan; the relationship with deployment and combat exposure; and the role that mental health problems, such as post-traumatic stress disorder (PTSD), have on the pathway between deployment and combat to violence. Seventeen studies published between January 1, 2001, and February 12, 2014, in the United States and the United Kingdom met the inclusion criteria. Despite methodological differences across studies, aggressive behavior was found to be prevalent among serving and formerly serving personnel, with pooled estimates of 10% (95% confidence interval (CI): 1, 20) for physical assault and 29% (95% CI: 25, 36) for all types of physical aggression in the last month, and worthy of further exploration. In both countries, rates were increased among combat-exp...

Download

The Use of Psychological Decompression in Military Operational Environments

Military Medicine, 2008

This article reviews the use of psychological decompression as applied to troops returning from a... more This article reviews the use of psychological decompression as applied to troops returning from active service in operational theaters. Definitions of the term are considered and a brief history is given. Current policies and practices are described and the question of mandatory decompression is considered. Finally, the evidence base for the efficacy of decompression is examined and some conclusions are drawn. This article highlights variations in the definition and practice of decompression and its use. Although there is, as yet, no evidence that decompression works, there is also no evidence to the contrary. Given the lack of knowledge as to the balance of risks and benefits of decompression and the absence of any definitive evidence that decompression is associated with improved mental health outcomes or that lack of decompression is associated with the reverse, it is argued that the use of decompression should remain a matter for discretion.

Download

50 Ways to Trace Your Veteran: Increasing Response Rates Can Be Cheap and Effective

European Journal of Psychotraumatology, 2010

UK armed forces responses to an informed consent policy for anthrax vaccination: A paradoxical effect?

Vaccine, 2006

Background: In recognition of concerns that anthrax vaccination might be a trigger for "Gulf war ... more Background: In recognition of concerns that anthrax vaccination might be a trigger for "Gulf war syndrome", anthrax vaccinations were offered to UK armed forces in the 2003 Iraq conflict using explicit as opposed to implicit consent, as is the policy for all other vaccinations. This paper examines responses of personnel to this policy. Methods: Qualitative analysis of free text responses to a question inviting comments on any concerns about the anthrax vaccination, asked in the context of a questionnaire assessing military health amongst 1000 members of the UK armed forces following the invasion of Iraq in 2003. Results: Two hundred and two (20.2%) respondents made comments reflecting concerns about the vaccine's effectiveness and its safety. These appeared to be magnified by suspicions about the motives behind the informed consent policy for anthrax but not other vaccinations. Conclusion: While the informed consent policy for anthrax vaccinations was intended to decrease concern, it may inadvertently have had the opposite effect.

Download

Irritable bowel syndrome in the UK military after deployment to Iraq: what are the risk factors?

Social Psychiatry and Psychiatric Epidemiology, 2013

An estimate of the veteran population in England: Based on data from the 2007 Adult Psychiatric Morbidity Survey

Population Trends, 2009

The impact of deployment length on the health and well-being of military personnel: a systematic review of the literature

Occupational and Environmental Medicine, 2010

To determine the current state of knowledge regarding the effects of deployment length and a ‘mis... more To determine the current state of knowledge regarding the effects of deployment length and a ‘mismatch’ between the expected and actual length of deployments on the health and well-being of military personnel in order to draw relevant conclusions for all organisations that deploy personnel to conflict zones. A systematic review was conducted of studies measuring deployment length to theatres of operations and the issue of ‘mismatch’ between expected and actual tour lengths. The nine studies included were rated for quality. Of the nine studies reviewed, six were rated as high quality, two as moderate quality and one as low quality. Seven of these studies found adverse effects of longer deployments on health and well-being. The two studies that measured ‘mismatch’ found adverse effects on mental health and well-being when deployments lasted longer than personnel expected. There are a limited number of studies which have assessed the effects of deployment length and very few that have ...

The psychological effects of improvised explosive devices (IEDs) on UK military personnel in Afghanistan

Occupational and Environmental Medicine, 2014

Gulf war illnesses

The Lancet, 2009

JVL no longer treats any patients but has used the unlicensed product in the past. He has receive... more

Download

Predicting persistent posttraumatic stress disorder (PTSD) in UK military personnel who served in Iraq: A longitudinal study

Journal of Psychiatric Research, 2012

In a longitudinal study we assessed which baseline risk factors are associated with persistent an... more In a longitudinal study we assessed which baseline risk factors are associated with persistent and partially remitted PTSD in comparison to fully remitted PTSD. 6427 (68%) of a randomly selected sample of UK service personnel completed the PTSD checklist (PCL) between 2004 and 2006 (Phase 1) and between 2007 and 2009 (Phase 2). 230 (3.9%) had possible PTSD at baseline. 66% of those with possible PTSD at baseline remitted (PCL score <30) or partially remitted (PCL score 30e49) by phase 2 of the study. Associations of persistent PTSD with the fully remitted group for risk factors at phase 1 adjusted for confounders were having discharged from service (OR 2.97, 95% CI 1.26e6.99), higher educational qualification (OR 2.74, 95% 1.23e6.08), feeling unsupported on return from deployment (OR 10.97, 95% CI 3.13e38.45), deployed not with parent unit (OR 5.63, 95% CI 1.45e21.85), multiple physical symptoms (OR 3.36, 95% CI 1.44e7.82), perception of poor or fair health (OR 2.84, 95% CI 1.28e6.27), older age and perception of risk to self (increasing with the number of events reported, p ¼ 0.04). Deploying but not with a parent unit and psychological distress were associated in the partially remitted PTSD when compared to the fully remitted group. The positive and negative likelihood ratios for the factors most highly associated with persistent PTSD indicated they were of marginal value to identify those whose presumed PTSD would be persistent. Many factors contribute to the persistence of PTSD but none alone is useful for clinical prediction.

Download

Stigma and mental health in the Royal Navy: A mixed methods paper

Journal of Mental Health, 2010

Combat exposure increases risk of alcohol misuse in military personnel following deployment

Evidence-Based Mental Health, 2009

Download

Do medical services personnel who deployed to the Iraq war have worse mental health than other deployed personnel?

The European Journal of Public Health, 2008

There is evidence of increased health care utilization by medical personnel (medics) compared to ... more There is evidence of increased health care utilization by medical personnel (medics) compared to other trades in the UK Armed Forces. The aim of this study was to compare the burden of mental ill health in deployed medics with all other trades during the Iraq war. Methods: Participants' main duty during deployment was identified from responses to a questionnaire and verified from Service databases. Psychological health outcomes included psychological distress, post-traumatic stress disorder, multiple physical symptoms, fatigue and heavy drinking. Results: A total of 479 out of 5824 participants had a medical role. Medics were more likely to report psychological distress (OR 1.30, 95% CI 1.00-1.70), multiple physical symptoms (OR 1.65, 95% CI 1.20-2.27) and, if men, fatigue (1.38, 95% CI 1.05-1.81) than other personnel. Female medics were less likely to report fatigue (0.57 95% CI 0.35-0.92). Neither post-traumatic stress disorder nor heavy drinking symptoms were associated with a medical role. Traumatic medical experiences, lower group cohesion and preparedness, and post-deployment experiences explained the positive associations with psychological ill health. Medics made greater use of medical facilities than other trades. Conclusions: There is a small excess of psychological ill health in medics, which can be explained by poorer group cohesion, traumatic medical and post-deployment experiences. The association of mental ill health with a medical role was not the consequence of a larger proportion of reservists in this group.

Download

Consent, confidentiality, and the Data Protection Act

BMJ, 2006

Laying Down Their Rifles: The Changing Influences on the Retention of Volunteer British Army Reservists Returning from Iraq, 2003—2006

Armed Forces & Society, 2009

U.K. Reserve Forces, principally the Territorial Army (TA), have been increasingly used since the... more U.K. Reserve Forces, principally the Territorial Army (TA), have been increasingly used since the end of the cold war, but there have been some concerns about their mental health problems and also possible unwillingness to remain in service. This article reports on the retention issues of 191 TA personnel who deployed to Iraq from 2003 to 2006. Qualitative data were thematically analyzed from three complementary studies. The authors found that, in 2003, negative aspects of Army organizational culture were reported as the prime reasons for TA personnel wishing to leave the military. In particular, Reservists reported their being unaccepted and underutilized. In contrast, by 2006, TA personnel were generally reporting being satisfied with their work as a Reservist and felt integrated with Regular colleagues. Those who stated they wanted to leave the military now reported it was primarily because of poor military family welfare support. These results suggest that although the British A...

Simon Wessely

Uploads

Papers by Simon Wessely

Log In