Military personnel can face unique risks and challenges to their mental health. High-stress situations, prolonged absences, and difficulty adjusting to civilian life can affect their mental health and hence develop psychiatric disorders , particularly major depressive disorder (MDD) and post-traumatic stress disorder( PTSD). That’s why searching for involved factors that could have an impact on these mental disorders or help predict them is crucial in the military population.

Our objectives were to describe the epidemiological profile of military patients followed in the psychiatric department of the military hospital of Tunis (MHT) and to identify the risk factors associated to psychiatric disorders in this population.

This was a retrospective study conducted over a period of 4 weeks , in the psychiatry department of the MHT. We included in our study patients drawn at random at the outpatient clinics, all psychiatric disorders included. We analyzed the epidemiological characteristics of the patients as well as the risk factors with the SPSS software 26.0.

One hundred military patients were included in our study. The mean age of the patients was 38.74(±9.73) years, 93% of them were male, 86% had a high school education, 71% belonged to middle socioeconomic category, and 59% lived in the military barracks. The mean duration of service was 17.68(±9.22) years. Active military members were assigned to weapons jobs (45%), administrative (15%), technical (24%), transportation (8%), and health (6%) specialities.We found that MDD was the main psychiatric disorder found in 64% of the patients with a mean severity of 76.9%. Besides , administrative specialities were the most frequent source of MDD (73.3%), while transportation posts were the most common cause of the PTSD (12.5%). And finally weapons specialties were the most likely to cause adjustment disorders (13.3%). In addition, we found that a long military service duration was associated with a chronic evolution of all the mental disorders (p :0.002).

The army is mostly affected by major depressive disorder . The position occupied by the patient seems to play a role in the type of the disorder . The seniority in the military service would be a risk factor for chronicity of the mental disorder.

None Declared

Therapeutic seclusion, consist of locking a patient alone in a room dedicated to this type of care. It poses real questions about respect for fundamental rights, in particular the right to liberty.

The objectives of our work were to evaluate the practices of psychiatric doctors and nurses in seclusion.

Our study is descriptive-based. Using a self-questionnaire, a set of questions about the decision of seclusion, its prescription, its means, its surveillance, the information of the patient and his relatives as well as the characteristic of the seclusion room, were asked. Our target population consisted of medical and paramedical staff working in the HMPIT Psychiatry Department.

Our study covered eleven doctors and fourteen nurses. The average age was 35 years with 52% having more than 5 years of psychiatric experience. Fifty-two percent used seclusion while 72% had no specific training. Twelve (12%) percent felt that no accidents could occur in seclusion. Twenty percent (20%) did not find it necessary to transcribe the monitoring parameters on the medical file.

Our study showed that the psychiatric staff lack sufficient exposure to in the area of therapeutic seclusion. A seclusion protocol has been drawn up to guarantee patient safety.

Posttraumatic stress disorder (PTSD) has a high prevalence and severe impact in military populations. Cognitive behavioral therapy (CBT) is indicated in this condition but it is a structured therapy that requires patients’ motivation and doctors’ availability.

Assess feasibility and effectiveness of CBT in a military group with PTSD.

A group of six militaries that witnessed the same traumatic event (an armed attack) and were diagnosed with PTSD were involved in a structured individual session CBT with one therapist. An assessment using the PTSD checklist for DSM (PCL) was performed initially and in halfway therapy. The therapy included an education about PTSD, a cognitive restructuring, a behavioral approach via home tasks and relaxation techniques.

The initial PCL scores varied from 25 to 55. All patients were initially on sick leave. Five patients had adjunctive antidepressant medications and one patient was only on therapy. Three patients showed no motivation and were excluded after 3 sessions. Two patients have had 7 weekly sessions and were able to return to work in the same place. One patient with severe PTSD had 2 sessions monthly, he had slight clinical improvement and could not come back to military work. The three patients who are still in therapy have improved PCL scores.

CBT can be effective in PTSD. The outcome depends on initial severity of PTSD and assiduity.

The authors have not supplied their declaration of competing interest.