Non-specific symptoms as clues to changes in emotional well-being

Background: Somatic symptoms are a common reason for visits to the family physician. The aim of this study was to examine the relation between non-specific symptoms and changes in emotional well-being and the degree to which the physician considers the possibility of mental distress when faced with such patients. Methods: Patients who complained of two or more symptoms including headache, dizziness, fatigue or weakness, palpitations and sleep disorders over one year were identified from the medical records of a random sample of 45 primary care physicians. A control group matched for gender and age was selected from the same population. Emotional well-being was assessed using the MOS-SF 36 in both groups. Results: The study group and the control group each contained 110 patients. Completed MOS questionnaires were obtained from 92 patients, 48 patients with somatic symptoms and 44 controls. Sixty percent of the patients with somatic symptoms experienced decreased emotional well being compared to 25% in the control group (p =0.00005). Symptoms of dizziness, fatigue and sleep disturbances were significantly linked with mental health impairments. Primary care physicians identified only 6 of 29 patients (21%) whose responses revealed functional limitations due to emotional problems as suffering from an emotional disorder and only 6 of 23 patients (26%) with a lack of emotional well being were diagnosed with an emotional disorder. Conclusions: Non-specific somatic symptoms may be clues to changes in emotional well-being. Improved recognition and recording of mental distress among patients who complain of these symptoms may enable better follow up and treatment

Mental Health of Canadian Armed Forces Veterans: Review of Population Studies

Introduction. The mental health of Canadian Armed Forces (CAF) populations emerged as an important concern in the wake of difficult CAF deployments in the 1990s. This article is the first comprehensive summary of findings from subsequent surveys of mental health and well-being in CAF Veterans, undertaken to inform mental health service renewals by CAF Health Services and Veterans Affairs Canada (VAC). Methods. Epidemiological findings in journal publications and government reports were summarized from four cross-sectional national surveys: a survey of Veterans participating in VAC programs in 1999 and three surveys of health and well-being representative of whole populations of Veterans in 2003, 2010, and 2013. Results. Although most Veterans had good mental health, many had mental health problems that affected functioning, well-being, and service utilization. Recent Veterans had a higher prevalence of mental health problems than the general Canadian population, earlier-era Veterans, and possibly the serving population. There were associations between mental health conditions and difficult adjustment to civilian life, physical health, and multiple socio-demographic factors. Mental health problems were key drivers of disability. Comparisons with other studies were complicated by methodological, era, and cultural differences. Discussion. The survey findings support ongoing multifactorial approaches to optimizing mental health and well-being in CAF Veterans, including strong military-to-civilian transition support and access to effective mental and physical health services. Studies underway of transitioning members and families in the peri-release period of the military-to-civilian transition and longitudinal studies of mental health in Veterans will address important knowledge gaps. (Article in English) Introduction : La santé mentale de la population des Forces armées canadiennes est devenue une préoccupation importante à la suite des déploiements difficiles des années 1990. Ceci est le premier résumé compréhensif des sondages qui ont suivi sur la santé mentale et le bien-être des vétérans des Forces armées canadiennes tenus par le groupe des services de santé des FAC et des Anciens Combattants Canada. Méthodologie : Les résultats épidémiologiques publiés dans les revues scientifiques et les rapports gouvernementaux sont les résumés de quatre enquêtes nationales transversales: un sondage des vétérans participant dans les programmes des Anciens Combattants Canada en 1999 et trois sondages sur la santé et le bien-être des vétérans en 2003, 2010 et 2013. Résultats: La majorité des vétérans présentaient une bonne santé mentale, mais un certain nombre de vétérans avaient des problèmes de santé qui affectaient leur bien-être, leur fonctionnement et leur utilisation des services. Les vétérans des années plus récentes ont une prévalence plus élevée de problèmes de santé mentale que la population canadienne en générale, que des vétérans plus âgés et possiblement que la population militaire. Les résultats montrent une association entre la condition de la santé mentale et une transition à la vie civile difficile, la santé physique, et plusieurs autres facteurs sociodémographiques. Les problèmes de santé mentale sont directement liés aux incapacités. Une comparaison à d\u27autres enquêtes étudiées serait difficile pour des raisons de méthodologie, d\u27ère et de différences culturelles. Conclusion : Les constatations de l\u27enquête supportent une approche multifonctionnelle pour optimiser la santé mentale et le-bien-être des vétérans des FAC, y compris un appui de taille et un accès à des traitements efficaces lors de la période de transition de la vie militaire à la vie civile. Des études longitudinales sur la santé mentale des vétérans aborderaient les lacunes