Papers (Military)

Papers (Military)


Ismail K, Everitt B, Blatchley N, Hull L, Unwin C, David A, Wessely S. Is there a Gulf war syndrome? Lancet 1999: 353: 179 182
There is a health problem, but no single syndrome

Jones E. War Syndromes: the Psychological Impact of Modern Warfare, A Study of the changing nature of pressure groups and government responses. Research Report, 1999.

Jones E, Wessely S. Chronic fatigue syndrome after the Crimean War and the Indian Mutiny. BMJ 1999: 319:1545-1547
First case reports of “Gulf War Syndrome” long before the Gulf War

Unwin C, Blatchley N, Coker W, Ferry S, Ismail K, Hotopf M, Palmer I, David A, Wessely S. The health of United Kingdom Servicemen who served in the Persian Gulf War. Lancet 1999:353: 169 178
First study to show that service in the 1991 Gulf War had affected the subjective health of part of the UK Armed Forces.

Hotopf M, David A, Hull L, Ismail K, Unwin C, Wessely S. The role of vaccinations as risk factors for ill-health in veterans of the Gulf War:cross sectional study. BMJ 2000:320:1363-1367
Reported a link between the very particular vaccination programme used to protect the Armed Forces against biological warfare and subsequent ill health. Led to important policy changes in UK forces health protection

Ismail K, Blatchley N, Hotopf M, Hull L, Palmer I, Unwin C, David A, Wessely S. Occupational risk factors for ill health in UK Gulf war veterans. J Epi Comm Health 2000; 54:834-838
Outlined main risk factors for ill health – showed could not be DU for example

Chalder T, Hull L, Unwin C, David A, Hotopf M, Wessely S. Prevalence of Gulf war veterans who think they have Gulf War Syndrome Br Med J 2001: 323;473-476
Social networks play a role

Jones E, Wessely S. Psychiatric battle casualties: an intra- and inter-war comparison. Br J Psych 2001: 178: 242-247
Physical and psychological casualties are closely linked – the greater the number of the former, the greater the latter

Jones E, Wessely S. The origins of British military psychiatry before the First World War. War and Society 2001: 19: 91-108

Reid S, Hotopf M, Hull L, Ismail K, Unwin C, David A, Wessely S. Chronic fatigue syndrome and multiple chemical sensitivity in UK Gulf war veterans. Am J Epidemiology 2001:153:604-609
Increase in several multi symptom conditions

Wessely S et al. Ten Years On: What Do We Know About the Gulf War Syndrome? Clinical Medicine (JRCPL) 2001; 1: 28-37

Wessely S, Hyams K, Bartholomew R. The Psychological Effects of Biological and Chemical Warfare. BMJ 2001: 323: 878-879.

Bartholomew R, Wessely S. The protean nature of mass sociogenic illness: From possessed nuns to chemical and biological terrorism fears. Br J Psychiatry 2002: 180: 300-306
Linked changing illness beliefs to outbreaks of mass hysteria in the age of terrorism

David A, Farrin L, Hull L, Unwin C, Wessely S, Wykes T, Cognitive functioning and disturbances of mood in UK veterans of the Persian Gulf War: a comparative study. Psychological Medicine 2002: 32: 1357-1370
Found no evidence of brain damage

Durodie W, Wessely S. Resilience or panic: the public’s response to a terrorist attack. Lancet 2002: 360: 1901-1902
Editorial on how risk communication can influence public reaction to terrorism

Everitt B, Ismail K, David A, Wessely S. Searching for a Gulf War Syndrome Using Cluster Analysis. Psych Med 2002: 32 1371-137
Different analysis to confirm no unique syndrome

Higgins E, Ismail K, Kant K, Harman K, Mellerio J, du Vivier A, Wessely S. Skin disease in Gulf War Veterans. Quart J Med 2002: 95: 671-676

Hotopf, M, Hull L, Unwin, C. David, A. Hyams K, Wessely, S. Self-Reported Health of Persian Gulf War Veterans: A Comparison of Help-Seeking and Randomly Ascertained Cases. Military Medicine 2002: 167:747-752

Hyams K, Murphy F, Wessely S. Combating terrorism: recommendations for dealing with the long term consequences of a chemical, biological attack. J Health Politics, Policy & Law 2002:27: 273-291
Short term effects will be well managed, long term problems will be difficult

Ismail K, Kent K, Brugha T, Hotopf M, Hull L, Seed P, Palmer I, Reid S, Unwin C, David A, Wessely S. . The mental health of UK Gulf war veterans: phase 2 of a two-phase cohort study. British Medical Journal 2002: 325: 576-579.
Doubling of psychiatric disorder, but PTSD not main issue. Alcohol and depression more important

Jones E, Hodgins-Vermaas R, McCartney H, Everitt B, Beech C, Poynter D, Palmer I, Hyams K, Wessely S. Post-combat syndromes from the Boer War to the Gulf: a cluster analysis of their nature and attribution. Br Med J 2002: 324: 321-324.
Used war pension records to show that Gulf War Syndrome is not as new as we think it is

Jones E, Palmer I, Wessely S. War Pensions (1900-1945): changing models of psychological understanding. Br J Psychiatry 2002: 180: 374-379.
Shows how the awarding of war pensions is socially influenced

Reid S, Hull K, Unwin C, Hotopf M, David A, Wessely S. Reported chemical sensitivities in a health survey of UK military personnel. Occupational & Environmental Health 2002: 59: 196-198

Sharief M, Pridden J, Delamont R, Unwin C, Rose M, David A, Wessely S. Neurophysiological evaluation of neuromuscular symptoms in UK Gulf War veterans. A controlled study. Neurology 2002: 59: 1518-1525
No evidence for peripheral neurological damage – and therefore organophosphate pesticides unlike to be playing a role in ill health

Skowera A, Stewart E, Davis E, Cleare A, Hossain G, Unwin C, Hull L, Ismail K, Wessely S, Peakman M. Antinuclear antibodies (ANA) in gulf war related illness and chronic fatigue syndrome (CFS) patients. Clin Exp Immunology 2002:129:354-358
Failed to replicate an earlier claim from USA

Unwin C, Hull L, Hotopf M, Ismail K, David A, Wessely S. Women in the Gulf: Lack of a Gender Difference in Long Term Health Effects in UK Armed Forces. Military Medicine 2002: 167: 406-413
No gender differences – women affected much the same as men

Wessely S, Chalder T, David A, Hotopf M, Ismail L, Jones E, Palmer I, Reid S, Unwin C. Ten Years On: What Do We Know About Gulf War Syndrome? In: Toxic Turmoil: Psychological and Societal Consequences of Ecological Disasters (ed Havenaar. Cwikel, Bromet), Plenum 2002: 101-128

Wessely, S. The Gulf War and its aftermath. Horizons in Medicine 2002: 13: 229-246.

Clauw D, Engel C, Kipen H, Jones E, Kroenke K, Ratzan S, Sharpe M, Wessely S. Unexplained symptoms after terrorism and war: an expert consensus statement. J Occup Environ Med 2003: 45: 1040-1048.

Greenberg N, Iversen A, Hull L, Unwin C, Destrange M, Wessely S. Vaccination records in Gulf War veterans. J Occupational and Environmental Medicine 2003: 45: 219
Ended the “prepped but not deployed” issue – only one valid record was found

Greenberg N, Thomas S, Iversen A, Unwin C, Hull L, Wessely S. Do military peacekeepers want to talk about their experiences? Perceived psychological support of UK military peacekeepers on return from deployment. J Mental Health 2003: 6: 565-573
Supports informal rather than formal interventions

Hotopf, M. David, A. Hull, L, Ismail I. Palmer, I. Unwin, C. Wessely, S. The health effects of peace-keeping in the UK Armed Forces: Bosnia 1992-1996. Predictors of psychological symptoms. Psychological Medicine 2003: 33: 1-8
Peacekeeping can be as difficult as war fighting

Hotopf, M. David, A. Hull, L. Nikalaou, V. Unwin, C. Wessely, S. Gulf War illness – better, worse or just the same? A cohort study. Br Med J. 2003;327:1370
Just the same – not getting worse, not getting better

Hotopf M, Mackness I, Nikolaou V, Collier D, David A, Durrington P, Hull L, Ismail K, Peakman M, Unwin C, Wessely S, Mackness B. Paraoxonase in Persian Gulf War veterans. Journal of Occupational and Environmental Medicine 2003: 45:668-675.
Failed to replicate claim that sick Gulf veterans have a particular variant of the enzyme that deals with organophosphates, but did show that the levels of this enzyme in the blood were lower in Gulf veterans than controls

Hull L, Farrin L, Unwin C, Everitt B, Wykes T, David A. Anger, psychopathology and cognitive inhibition: A study of UK servicemen. Personality and Individual Differences 2003: 35: 1211-1226

Jones E, Hodgins Vermaas R, Beech C, Palmer I, Hyams K, Wessely S. Mortality and post-combat disorders: UK veterans of the Boer War and World War One. Military Medicine 2003: 168:414-418
Shell shock, effort syndrome etc not associated with increased mortality, much like gulf war illness

Jones E, Hyams K, Wessely S. Screening for Psychological Vulnerability in the Military: A historical analysis. J Med Screening 2003, 10: 40-46
Don’t do it – was done in World War II and was a disaster

Jones, E., Vermaas, R., McCartney, H. Beech, C., Palmer, I., Hyams, K. Wessely, S. Flashbacks and post-traumatic stress disorder: the genesis of a 20th-century diagnosis. British Journal of Psychiatry 2003, 182, 158-163.
Paper that suggests that PTSD is not a “hard wired” response, but more culturally determined

Jones E, Wessely S. The impact of total war on the practice of psychiatry. In: Shadows of Total War, 1919 1939. (Ed Forster, Chickering). Cambridge Univ Press 2003: 129-148.
It was the Second, not the First World War that changed the practice of psychiatry

Jones E, Wessely S. Forward Psychiatry in the Military: Its Origins and Effectiveness. J Traumatic Stress 2003:16:411-419
Discusses the origins of the standard way in which most Armed Forces treat acute psychiatric casualties, whilst concluding that we will probably never know if this is effective or not

Wessely S, Unwin C, Hotopf M, Hull L, Ismail K, Nicolaou V, David A. Is recall of military hazards stable over time? Evidence from the Gulf War. Br J Psych 2003: 183:314-322
No it isn’t. Self report of exposure to some military hazards unreliable over time

French C, Rona RJ, Jones M, Wessely S. Screening for physical and psychological illness in the British Armed Forces: II Barriers to screening – learning from the opinions of Service personnel. J Medical Screening 2004; 11: 153-157
Problems include stigma, confidence and confidentiality

Greenberg N, Iversen A, Unwin C, Wessely S. Screening for depleted uranium in members of the UK Armed Forces: Who wants it and why? J Epi Comm Health 2004: 58:558-561

Hotopf M, David A, Hull L, Nikalaou V, Unwin C, Wessely S. Risk factors for continued illness among gulf war veterans: a cohort study. Psychological Medicine 2004: 34: 1-8
Emphasised that social/psychological factors were important in prognosis

Iversen, A. & Greenberg, N. Food for thought: Participating and managing the psychological aspects of food chain contamination and terrorism. Psychiatric Annals 2004, 34.

Jones E, Wessely S. Hearts, Guts and Minds: Somatisation in the Military from 1900. J Psychosomatic Research 2004: 56: 425-429

Jones E, Woolven, R, Durodié B, Wessely S. Civilian Morale during World War Two: responses to air-raids re-examined. Social History of Medicine 2004: 17: 463-79.
Fears of mass panic/social disintegration were exaggerated before the Blitz

Nisenbaum R, Wessely S, Unwin C, Hull L, Ismail K, Reeves W. Dichotomous factor analysis of symptoms reported by UK and US veterans of the Gulf War. Population Health Metrics 2004: 2: 8

Richie E, Friedman M, Watson P, Ursano R, Wessely S, Flynn B. Mass violence and early mental health intervention: a proposed application of best practice guidelines to chemical, biological and radiological attacks. Military Medicine 2004: 169: 575-579

Rona RJ, Hooper R, Jones M, French C, Wessely S. Screening for physical and psychological illness in the British Armed Forces: III The value of a questionnaire to assist a Medical Officer to decide who needs help. J Medical Screening 2004 ; 11: 158-161
Psychological tests not helpful for mental health screening in the context of the UK military

Rona R J, Jones M, French C, Hooper R, Wessely S. Screening for physical and psychological illness in the British Armed Forces: I The acceptability of the programme. J Medical Screening 2004; 11: 148-153
It is not acceptable for many reasons, and will not work until those are sorted

Rose, M. R., Sharief, M. K., Priddin, J., Nikolaou, V., Hull, L., Unwin, C., Ajmal-Ali, R., Sherwood, R. A., Spellman, A., David, A., Wessely, S. Evaluation of Neuromuscular Symptoms in UK Gulf War Veterans. A Controlled Study. Neurology 2004: 63: 1681-1687
Ill gulf veterans found physical exercise more demanding than controls. Found evidence that the mitochondria in muscle cells were working less efficiently, but unable to say if this was cause or effect

Skowera A, Hotopf M, Sawicka E, Varela-Calvino R, Unwin C, Nikolau V, Hull L, Ismail K, David AS, Wessely S, Peakman M. Cellular Immune activation in Gulf War veterans. J Clin Immunology 2004: 24: 60-73

Wessely S. The Long Aftermath of the 1991 Gulf War. Annals Int Med 2004: 141: 155-156
Editorial on treatment

Wessely S. When being upset is not a mental health problem. Psychiatry 2004: 67: 153-157
Why it is important to distinguish between normal symptoms of distress and psychiatric disorder

Wessely S, Jones E. Psychiatry and the “Lessons of Vietnam?”: What were they, and are they still relevant? War and Society 2004: 22: 89-103
Paper used in PTSD case to show that UK military could not be blamed for failing to learn the lessons of Vietnam, because no one knew what they were

French, C. Dandeker, C. UK military families and the deployments to Iraq: Preliminary findings from a pre-, during-, and post-deployment study of the British Army. Paper presented at the 2005 Inter-University Seminar on Armed Forces and Society. Chicago, October 2005

Wives are more resilient than their service partners think they are when facing the stresses of separation due to deployment

French, C. Dandeker, C. Birtles, C. & Wessely, S. The family and military as ‘Greedy Institutions’: Negotiating a work-life balance in the British Armed Forces. A report prepared for the Economic and Social Research Council, November 2005.
Analyses tensions between work and family life in the military setting

Hacker Hughes J, Cameron F, Eldridge R, Greenberg N, Wessely S. Going to war does not always have to hurt: preliminary findings from the British deployment to Iraq. Br J Psych 2005: 186: 536-537
Not the best title, but showed that in elite forces (16 AA Bde) Op TELIC 1 was associated with an improvement in mental health

Hooper R, Rona R, French C, Jones M, Wessely S. Unmet expectations in primary care and the agreement between doctor and patient: a questionnaire study. Health Expectations 2005: 8: 26-33
Patients (all of them in the Armed Forces) and doctors have different views on what actions the doctor took during a consultation, and these conflicting perspectives may or may not fulfil patient’s expectations

Hotopf M, Wessely S. Can epidemiology clear the fog of war? Lessons from the first Gulf War. Int J Epidemiology 2005: 34: 791-800
Review of the problems in carrying out this kind of research after deployment

Iversen A, Dyson C, Smith N, Greenberg N, Walwyn R, Unwin C, Hull L, Dandeker C, Ross J, Wessely S. “Goodbye and Good Luck”; the Mental Health Needs and Treatment Experiences of British Ex Service Personnel. Br J Psychiatry 2005: 186: 480-486
Many of those with continuing mental health problems do not access the best treatments once they have left the Armed Forces. Began what would become a continuing theme of our work – that PTSD is not the only, or the commonest, mental health problem affecting veterans

Iversen A, Nicolaou V, Unwin C, Greenberg N, Dandeker C, Ross, J, Wessely S. What happens to UK veterans when they leave the Armed Forces? Eur J Public Health 2005: 15:175-184
Most get jobs and do well, a few don’t

Jones E, Wessely S. From Shellshock to PTSD: Military Psychiatry from 1900 to the Gulf War. Hove: Psychology Press, 2005.
Historical account of the development of military psychiatry

Jones E, Wessely S. War Syndromes: the impact of culture on medically unexplained symptoms, Medical History 2005: 49: 55-78.
Broad review of unexplained syndromes in the military

Rona R, Hyams C, Wessely S. Screening for psychological illness in military personnel. JAMA 2005: 293: 1257-1260
Response to US programme setting out reasons why UK has not followed suit

Rubin J, Brewin C, Greenberg N, Simpson J, Wessely S. Psychological and behavioural reactions to the bombings in London on 7 July 2005: cross sectional survey of a representative sample of Londoners. British Medical Journal 2005. 311: 606-610

Skowera A, de Jong E, Schuitemaker J, Wessely S, Griffiths G, Kapsenberg M, Peakman M. Impairment of dendritic cell maturation and effector function by vaccines used for protection against anthrax and plague. J Immunology 2005: 175: 7235-7243.

Van Staden L, French C, Iversen A, Dandeker C, Wessely S. Post discharge mentoring for vulnerable service leavers. Unpublished Research Report, MOD 2005.

Wessely S. What should mental health professionals do, and not do. In: Neria Y, Gross R, Marshall R, Susser E, eds. 9/11: Mental Health in the Wake of a Terrorist Attack. New York: Cambridge University Press, 2005.

Wessely S. Don’t Panic!: Short and Long Term Psychological Reactions to the New Terrorism: The Role of Information and the Authorities. J Mental Health 2005: 14: 1-6
Developing themes of civilian resilience and communication

Wessely S. Victimhood and Resilience. New England Journal of Medicine 2005: 353: 548-550

Wessely S. War Stories. Br J Psychiatry 2005: 186: 473-475
Importance of understanding recall bias – memory is a human function, and soldiers can sometimes forget things that happened to them, or remember things that didn’t .

Wessely S. Risk, psychiatry and the military. Br J Psychiatry 2005: 186: 459-466
Reflections on risk and the Armed Forces

Wessely S, Hotopf M. Something Old, Something New, Something Borrowed, Something Blue: The Story of “Gulf War Syndrome”. In: Medical and Psychiatric Comorbidity over the Course of Life. Ed Easton W. APPI, Washington.
One more review

Wessely S, Krasnov V (eds). Psychological Aspects of the New Terrorism: A NATO Russia Dialogue. IOS Press, 2005.

Allen J, Skowera A, Rubin J, Hotopf M, Wessely S, Peakman M. Long-lasting T cell responses to biological warfare vaccines in human vaccines. Clin Infect Dis 2006: 43:1-7

Dandeker C, Iversen A, Ross J, Wessely S. What’s in a Name? Defining and caring for ‘veterans’: the United Kingdom from a comparative perspective? Armed Forces and Society 2006: 32: 161

French C, Dandeker C, van Staden L, Wessely S. Deployment of British Army Reserves on Op TELIC 5: Expectations, experiences and impact on retention. Unpublished Research Report. MOD, 2006.
Reservists and Regulars differ less on what they experience on deployment and more on how they are treated when they come home

French, C. Dandeker, C & Wessely, S. Deployment of British Army reservists on Op TELIC 5: Deployment related stressors and the overall affect on retention. Submitted to 9th International Military Mental Health Conference on “The Unhappy Soldier: The Management of Disenchanted Service Personnel”, RMAS 2006.

Horn O, Hull L, Jones M, Murphy D, Browne T, Fear NT, Hotopf M, Rona R, Wessely S. Is there an “Iraq War Syndrome”? Comparison of the health of UK service personnel after the Gulf and Iraq wars. Lancet 2006: 367: 1742-1746
History has not repeated itself. Raises interesting questions about why not

Hotopf M, Hull L, Fear N, Browne T, Horn O, Iversen A, Jones M, Murphy D, Bland D, Earnshaw M, Greenberg N, Hacker-Hughes J, Tate R, Dandeker C, Rona R, Wessely S. The health of UK military personnel who deployed to the 2003 Iraq War. Lancet 2006: 367: 1731-1741
Key paper showing that between 2003 and 2006 there was no increase in psychiatric problems in Regular personnel who had served in Iraq from the initial invasion to the shift to counter insurgency. This contrasted with the US experience. However, there was a significant increase in psychiatric disorders in Reservists associated with service in Iraq

Hotopf M, Fear N, Hull L, Rona R, Wessely S. Post-traumatic stress disorder in UK and US forces deployed to Iraq – Author’s reply. Lancet 2006; 368: 837.

Hotopf M, Wessely S. Neuropsychological changes following military service in Iraq: case proven, but what is the significance? JAMA 2006: 296: 574-575

Iversen A, Liddell K, Fear N, Hotopf M, Wessely S. Consent, Confidentiality and the Data Protection Act: Epidemiological Research and hard-to-engage Cohorts. Br Med J 2006: 332: 165-169
Uses data from our Gulf and Iraq studies to show that the main obstacle to using personal medical information in key research is faulty understanding of the Data Protection Act, and not as is often claimed the law itself

Jones E, Hyams K, Wessely S. Iconic Images. The Historian 2006: 92,6-11.

Jones E, Woolven R, Durodie W, Wessely S. Public Panic and Morale: World War Two civilian responses re-examined in the light of the current anti-terrorist campaign. Journal of Risk Research 2006: 9, 57-73.
Links population reactions to terror over 50 years

Jones M, Rona R, Hooper R, Wessely S. The burden of psychological illness in the UK Armed Forces. Occupational and Environmental Medicine 2006: 56:322-328

McGeorge T, Hacker Hughes H, Wessely S. The MOD PTSD Class Action – A Psychiatric Perspective. Occupational Health Review 2006: 122: 21-28
Summary of the large class action brought unsuccessfully by veterans against MOD in 2003. What is the duty of care re stress/PTSD? What must MOD do in future? What does it not need to do?

Murphy D, Dandeker C, Horn O, Hotopf M, Hull L, Jones M, Marteau T, Rona R, Wessely S. UK Armed Forces response to an informed consent policy for anthrax vaccination: A paradoxical effect? Vaccine 2006: 24: 3109-3114
Changing to informed consent for anthrax vaccine in Armed Forces has caused confusion and not increased confidence

Murphy D, Hooper C, French C, Jones M, Rona R, Wessely S. Is increased reporting of symptomatic ill health in Gulf War veterans related to how one asks the question? J Psychosom Res 2006: 61: 181-186
No it isn’t – important confirmation that the Gulf Health effect is not an artefact of knowing you went to the Gulf

Rona R, Hooper R, French C, Jones M, Wessely S. The meaning of self perception of health in the UK Armed Forces. Br J Health Psychology 2006: 11: 703-715
Points out that the Armed Forces often score highly on questionnaire self reports of ill health, but this does not mean that their health is impaired

Rona R, Hooper R, Greenberg N, Jones M, Wessely S. Medical downgrading, self-perception of health and psychological symptoms in the British Armed Forces. Occupational and Environmental Medicine 2006: 63: 250-254
Those who are downgraded for longer periods of time with physical problems often have psychological distress as well

Rona R, Hooper R, Jones M, Hull L, Browne T, Horn O, Murphy D, Hotopf M, Wessely S. Would mental health screening of the UK Armed Forces before the Iraq War have prevented subsequent psychological morbidity? Br Med J 2006: 333: 991-994
Using before/after data we show that mental health screening would not have prevented mental health problems after Iraq

Shephard B, Rubin J, Wardman J, Wessely S. Terrorism and dispelling the myth of a panic prone public. Journal of Public Health Policy 2006: 27:219-245
Extends the arguments and evidence from the Blitz to the present day

Stimpson N, Hull L, Unwin C, Lewis G, David A, Wessely S. Prevalence of reported pain, widespread pain and pain symmetry in veterans of the Gulf War. The use of pain manikins in Gulf Health research. Military Medicine 2006: 171, 1181-1186

Wessely S. Twentieth century theories on combat motivation and breakdown. J Contemp Hist 2006: 41: 268-286
A historical paper outlining how the military and the psychiatrists used to think in a similar fashion about why men fight, and why they cease to fight, but since the coming of PTSD these views have diverged

Wessely S. The Life and Death of Private Harry Farr. J Royal Soc Medicine 2006: 99:440-443 and RUSI Journal
Harry Farr was one of those executed for military offences during the First World War. This paper looks at why things happened the way they did, and raises questions about the dangers of rewriting history through our modern sensibilities

Wessely S, Freedman L. Reflections on Gulf Illness. Philosophical Transactions of the Royal Society 2006: 361: 721-730
A brief summing up of what we know, and what we don’t know

Wessely S, Thomas S, Dandeker C, Greenberg N, Kelly V. “Serving in Bosnia made me appreciate living in Bristol”: Stressful Experiences, Attitudes, and Psychological Needs of Members of the United Kingdom Armed Forces. Mil Medicine 2006: 171: 376-380
Paper highlighting both the positive and negative aspects of peace keeping, and adds to the evidence that peacekeeping is associated with different psychological challenges than traditional war fighting

Bland D, Rona R, Coggan D, Anderson J, Greenberg N, Hull L, Wessely S. Urinary isotopic analysis in the UK Armed Forces: No evidence of depleted uranium absorption in combat and other exposed personnel in Iraq. Occupational and Environmental Medicine 2007: 64; 834-838

Browne T, Hull L, Horn O, Jones M, Murphy D, Fear N, Greenberg N, French C, Rona R, Wessely S, Hotopf M. Explanations for the increase in mental health problems in UK Reserve Forces who have served in Iraq. Br J Psychiatry 2007: 190: 484-489
Showed how problems at home and problems adjusting to homecoming played an important role in the increase in PTSD symptoms that we found as a result of deployment in UK Reservists

Fear N, Iversen A, Meltzer H, Workman L, Hull L, Greenberg N, Earnshaw M, Rona R, Hotopf M, Wessely S. Do the UK Armed Forces drink more than the general population? Patterns of drinking in the military and comparisons with the general population? Addictions 2007: 102: 1749-1759
The answer to the question is yes they do, and the differences between the military and the general population are most marked in young women. This is partly explained by selection – the Services recruit young people, some of whom already are prone to heavier drinking. However, other factors also play a part, such as culture, price and availability

Iversen A, Chalder T, Wessely S. “Gulf War Syndrome”: Lessons from Medically Unexplained Symptoms. Clinical Psychology Review 2007: 27: 842-854
A review paper proposing that we need now to look at Gulf War illness in a similar fashion to the way we think about illnesses such as chronic fatigue syndrome, irritable bowel syndrome and other unexplained syndromes to think more about why veterans are either staying ill or not getting better, and put to one side the vexed question of what started the problem in the first place

Iversen A, Drinkwater A, Fear N, Greenberg N, Barker C, Hotopf M, Hull L, Wessely S. Factors associated with heavy alcohol consumption in the UK Armed Forces: Data from a health survey of Gulf, Bosnia and Era veterans. Military Medicine 2007: 172: 925-930.

Iversen A, Fear N, Simonoff E, Hull L, Horn O, Greenberg N, Hotopf M, Rona R, Wessely S. Pre enlistment vulnerability factors and their influence on health outcomes in UK Military personnel. Br J Psychiatry 2007: 191: 506-511.

Iversen A, Morriss R, Greenberg N, Wessely S. Bridging the Gulf: “Gulf War Syndrome”: What we know and what we don’t. Advances in Clinical Neurosciences and Rehabilitation 2007: 7; 6-7

Jones E, Fear N, Wessely S. Shell Shock and Mild Traumatic Brain Injury: A Historical Review. Am J Psychiatry 2007: 164,1641-1645
A historical paper outlining the early history of “shell shock” during the First World War, emphasising shifting perspectives, beginning with the belief this was a form of head injury, before more psychological and/or social paradigms took over. One hopes the reader will notice the analogies with the current debate over mTBI

Jones N, Greenberg N, Wessely S. No plans survive first contact with the enemy: flexibility and improvisation in disaster mental health. Psychiatry 2007: 70: 361-365

Jones E, Palmer I, Wessely S. Enduring beliefs about the effects of gassing in war: qualitative study. BMJ 2007: 335: 1313-1315

Jones E, Wessely S. Post traumatic stress disorder: a paradigm shift in the conceptualization of psychiatric disorder. J Anxiety Disorders 2007: 21: 164-175
What did we think about trauma and psychiatry before we had PTSD?

Murphy D, Hull L, Horn O, Jones M, Browne T, Marteau T, Rona R, Hotopf M, Wessely S. Anthrax vaccination in a military population before the war in Iraq: acceptance, side effects and choice. Vaccine 2007: 25; 7641-7648

Rogers B, Amlot R, Rubin G, Wessely S, Krieger K. Mediating the social and psychological impact of terrorist attacks: the role of risk perception and risk communication. Int Review of Psychiatry 2007: 19: 279-288

Rona R, Fear N, Hull L, Greenberg N, Earnshaw M, Hotopf M, Wessely S. The mental health consequences of “overstretch” in the UK Armed Forces. BMJ 2007: 335: 603-607
No link between number or length of deployments and mental health, provided the “Harmony Guidelines” are observed. If they are not, and in particular if tour length is unexpectedly increased, then there are increases in both PTSD and alcohol

Rona R, Fear N, Hull L, Wessely S. Women in novel occupational roles: mental health trends in the UK Armed Forces. International Journal of Epidemiology 2007; 36: 319-327
Women have higher prevalence rates of mental illness than men with the exception of alcohol misuse. However, the effects of deployment are similar for both sexes

Rubin G, Brewin C, Greenberg N, Hacker Hughes J, Simpson J, Wessely S. Enduring consequences of terrorism: 7 month follow up survey of reactions to the bombings in London on 7 July 2005, Br J Psych 2007: 190: 350-356
Demonstrated emotional and behavioural reactions in ordinary Londoners ten days after July 7th attacks

Rubin G, Page L, Morgan O, Pinder R, Riley P, Hatch S, Maguire H, Catchpole M, Simpson J, Wessely S. Public information needs after the poisoning of Alexander Litvinenko with polonium-210 in London: Cross sectional telephone survey and qualitative analysis. BMJ 2007: 335: 1143-1146.

Tarn M, Greenberg N, Wessely S. “Gulf War Syndrome”: Has it Gone Away? Advances in Psychiatric Treatment 2008

Tate R, Jones M, Fear N, Hull L, Rona R, Wessely S, Hotopf M, How many mailouts? Could attempts to increase the response rate in the Iraq war cohort study be counter productive?. BMC Medical Research Methodology 2007, 7:51

Van Staden LN, Fear N, Iversen A, French C, Dandeker C, Wessely S. Young military veterans show similar help seeking behaviour. Br Med J 2007; 334: 382.

Van Staden L, Fear NT, Iversen A., French C, Dandeker C, Wessely S. Transition back into civilian life: A study of personnel leaving the UK Armed Forces via “military prison”. Military Medicine 2007: 172: 925-930

Browne T, Fear N, Hull L, Workman L, Iversen A, Horn O, Jones M, Murphy D, Greenberg N, Rona R, Hotopf M, Wessely S. Experiences in Iraq: how do they effect alcohol consumption among male UK military personnel? Occupational & Environmental Medicine 2008: 65: 628-633

Cohn S, Dyson C, Wessely S. Early accounts of Gulf War illness and the construction of narratives in UK service personnel. Social Science and Medicine 2008; 67: 1641-1649
An anthropological perspective using free text accounts given by study respondents to our first Gulf study, showing how uncertainty, rumours and information gaps played a role in how veterans started to make sense of their symptoms

Fear N, Iversen A, Chatterjee A, Hull L, Rona R, Hotopf M, Wessely S. Risky driving behaviours among regular UK Armed Forces personnel. Am J Preventive Medicine 2008: 35: 230-236

Greenberg N, Iversen A, Hull L, Bland D, Wessely S. “Getting a peace of the action”: Measures of Post Traumatic Stress in UK military peacekeepers. J Royal Soc Medicine 2008: 101: 78-84

Hacker Hughes J, Earnshaw M, Greenberg N, Eldridge R, Fear N, French C, Deahl M, Wessely S. The use of psychological decompression in military operational environments. Mil Medicine 2008: 173: 534-538
Why decompression might be useful, why it is popular, and why there is scant evidence to suggest that it actually is beneficial

Hooper R, Rona R, Jones M, Fear N, Hull L, Wessely S. Cigarette and alcohol use in the UK Armed Forces, and their association with combat exposure; a prospective study. Addictive Behaviors 2008: 33: 1067-1071
Alcohol consumption and binge drinking has increased over time. The increase of consumption is greater in those who have been deployed, but the increase was strongest in those most recently deployed. Smoking is declining.

Ismail K, Sherwood R, Kent K, Hull L, Seed P, David A, Wessely S. Chronic fatigue syndrome and related disorders in UK veterans of the 1991 Gulf War: results from a two phase cohort study. Psychological Medicine 2008: 38: 953-951

Iversen A, Fear N, Ehlers A, Hacker Hughes J, Hull L, Earnshaw, M, Greenberg N, Rona R, Wessely S, Hotopf M. Risk Factors for Post traumatic stress disorder in United Kingdom Armed Forces. Psych Med 2008: 38: 511-522
As expected PTSD was associated with traumatic events in theatre, most particularly believing one’s life was in danger. But it was also associated with early adversity, such as poor school record and childhood adversity. Low morale and poor social support within the unit also played a role

Jones E, Everitt B, Ironside S, Palmer I, Wessely S. Psychological effects of chemical weapons: a follow up study of First World War veterans. Psych Med 2008: 38: 1419-1426

Jones M, Fear N, Greenberg N, Jones N, Hull L, Hotopf M, Wessely S. Rona R. Do medical personnel deployed to Iraq have worse mental health than other personnel? Eur J Public Health 2008: 18; 422-427
Unfortunately yes they do, although this had improved by 2009

Jones N, Greenberg N, Fear N, Earnshaw M, McAllister P, Reid G, Wessely S. The operational mental health consequences of deployment to Iraq for UK Forces. Journal of the Royal Army Medical Corps 2008: 154; 101-105

Murphy D, Hotopf M, Marteau T, Wessely S. Multiple vaccinations, health and recall bias in UK Armed Forces deployed to Iraq. BMJ 2008: 337: a220
Using data from the Iraq deployment, showed no link between multiple vaccines and ill health, except when using self report. Suggested that our previous findings of such a link after the Gulf War may despite all efforts still have been influenced by recall bias

Murphy D, Iversen A, Greenberg N. The Mental Health of Veterans. Journal of the Royal Army Medical Corps. 2008: 154: 135-138

Murphy D, Marteau T, Hotopf M, Rona R, Wessely S. Why do UK military personnel refuse the anthrax vaccination? Biosecurity and Bioterrorism 2008: 6: 237-242
Because they no longer believe there is a realistic threat

Page L, Rubin J, Amlot R, Simpson J, Wessely S. Are Londoners prepared for an emergency? A longitudinal study following the London bombs. Bioterrorism and Biosecurity. Biosecurity and Bioterrorism: Biodefense Strategy, Practice, and Science. 2008, 6: 309-320.
Do we need to say? No they are not.

Sharpley J, Fear NT, Greenberg N, Hacker Hughes J, Jones M, Wessely S. Pre-Operational Stress Briefing: Does it have any effect? A comparison of Royal Naval and Royal Marine personnel receiving a pre-operational stress briefing before the invasion of Iraq with a group of personnel who did not. Occupational Medicine 2008: 58: 30-34.

Stuart J, Ursano R, Fullerton C, Wessely S. Belief in exposure to chemical and biological agents in Persian Gulf War soldiers. J Nerv Mental Diseases 2008: 196: 122-127
Shows how those who believe that they were exposed to CBW agents as a result of their Gulf service are substantially more likely to have long term symptomatic ill health. Given that the evidence of any exposure is far from compelling, shows both the dangers of recall bias and also the influence of illness beliefs on health

Greenberg N, Wessely S. “Gulf War Syndrome”: an emerging threat or a part of history? Emerging Health Threats 2008: 1:e10. doi: 10.3134/ehtj.08.010

Wilson J, Jones M, Hull L, Hotopf M, Wessely S, Rona R. Does prior psychological health influence recall of military experiences? A prospective study. J Traumatic Stress 2008: 21: 385-393
Is that more vulnerable people simply recall more traumatic exposures? A little, but not sufficient to suggest that predeployment psychological status would be useful for correcting for recall bias

Wessely S, Bryant R, Greenberg N, Earnshaw M, Sharpley J, Hacker Hughes J. Does psycho education help prevent post traumatic distress? Psychiatry 2008: 71: 287-302

Fear N, Jones E, Groom M, Greenberg N, Hull L, Hodges T, Wessely S. Symptoms of post concussional syndrome are non specifically related to mild traumatic brain injury in UK Armed Forces personnel on return from deployment in Iraq. An analysis of self reported data. Psychological Medicine 2009: 39: 1379-1387

The symptoms of mTBI (or post concussional syndrome as the UK prefers to call it) are linked with self reported exposure to blast injuries, as one would predict, but also with several other traumas/exposures that have nothing to do with concussion.

Fear N, Ward VR, Harrison K, Davison L, Williamson S, Blatchley NF. Suicide among male regular UK Armed Forces personnel, 1984-2007. Occupational & Environmental Medicine 2009: 66: 438-441
Overall the Armed Forces have a lower suicide rate than the general population, the exception being young men in the Army

Fear N, Rubin G, Hatch S, Hull L, Jones M, Hotopf M, Wessely S, Rona R. Job strain, rank and mental health in the UK Armed Forces. Int J Occup Env Health 2009: 15;291-298.

Greenberg N, Langston V, Fear NT, Jones M, Wessely S. An evaluation of stress education in the Royal Navy. Occupational Medicine 2009; 59: 20-24.
Although stress education is now almost impossible to avoid, most military personnel do not recall ever have received any. Those who did remember and also found it helpful reported better mental health – no differences were found if briefings were perceived as being unhelpful.

Greenberg N, Wessely S. The dangers of inflation: memories of trauma and post traumatic stress disorder. Br J Psychiatry 2009: 194: 479-480

Iversen A, van Staden L, Birtles C, Hacker Hughes J, Browne T, Langston V, Hull L, Hall J, Greenberg N, Rona R, Hotopf M, Wessely S, Fear N. The prevalence of common mental disorders and PTSD in the UK Military using data from a clinical interview-based study. BMC Psychiatry 2009:9:68

Jones N, Fear N, Greenberg N, Hull L, Wessely S. Occupational outcomes in soldiers admitted to hospital for treatment of mental health problems. Occupational Medicine 2009: 59: 459-465
Generally poor, especially in those with short employment histories and/or substance misuse problems

Langston V, Greenberg N, Jones M, Fear N. Wessely S. An evaluation of stress education in the Royal Navy. Occupational Medicine 2009: 59: 20-24

Murphy D, Greenberg N, Bland D. Health concerns in UK Armed Forces personnel. J R Soc Med 2009: 102: 143–147.

Pinder R, Murphy D, Hatch S, Iversen A, Dandeker C, Wessely S. A Mixed Methods Analysis of the Perceptions of the Media by Members of the British Forces during the Iraq War. Armed Forces and Society 2009: 36: 131-152

Rona R, Jones M,Iversen A, Hull L, Greenberg N, Hotopf M, Wessely S. The impact of post traumatic stress disorder on impairment in the UK military at the time of the Iraq war. J Psychiatric Research 2009: 43: 649-655
Social and work impairment is a serious problem for those with PTSD and even for those who only have partial PTSD

Rona R, Hooper R, Jones M, Iversen A, Hull L, Murphy D, Hotopf M, Wessely S. The contribution of prior psychological symptoms and combat exposure to post Iraq deployment mental health in the UK military. Journal of Traumatic Stress 2009: 22: 11-19

Wessely S, Greenberg N, Woodhead C, Fear N. Gulf war illnesses. Lancet 2009; 373:462.

Wilson J, Jones M, Fear N, Rona R, Hull L, Hotopf M, Wessely S, Rona R. Was previous psychological health associated with the likelihood of being sent to Iraq for the UK Military? Investigating the “healthy warrior” effect. Am J Epidemiology 2009: 169: 1362-1369
A small “healthy warrior” effect was demonstrated

Woodhead C, Sloggett A, Bray I, Bradbury J, McManus S, Meltzer H, Brugha T, Jenkins R, Greenberg N, Wessely S, Fear N. An estimate of the veteran population in England: based on data from the 2007 Adult Psychiatric Morbidity Survey. Population Trends 2009: 138:50-54
Using this population based study, to which we had added a couple of questions on military service, we estimated that the total number of ex service personnel in England in 2007 was 3,770,000, close to the previous estimate made by the Royal British Legion.

Fear NT, Horn O, Hull L, Murphy D, Jones M, Browne T, Hotopf M, Wessely S, Rona R. Smoking in the UK Armed Forces: Changes over a seven year period. Preventive Medicine, 2010: 50: 282-284

Fear NT, Jones M, Murphy D, Hull L, Iversen A, Coker B, Machell L, Sundin J, Woodhead C, Jones N, Greenberg N, Landau S, Dandeker C, Rona R, Hotopf M, Wessely S. What are the consequences of deployment to Iraq and Afghanistan on the mental health of the UK Armed Forces? A cohort study. Lancet 2010: 375: 1783- 1797.
Main results of the follow up study. Overall mental health of Armed Forces remains robust. No overall increase in PTSD following deployment to either Iraq or Afghanistan in Regulars, but increases in combat troops and Reservists. Situation stable from 2003 to 2009. Impact of deployment on alcohol misuse. No impact of number of deployments. Only a very small increase in PTSD over time since return – i.e. no “tidal wave”.

Fear N, Van Staden L, Iversen A, Hall J, Wessely S. “50 ways to trace your veteran”: increasing response rates can be cheap and effective. European Journal of Psychotraumatology 2010, 1: 5516 – DOI: 10.3402/ejpt.v1i0.5516
Reminder to people thinking of doing this kind of research – it’s very difficult!

French C, Dandeker C , Greenberg N, Riley P, van Staden L, Hatch S, Wessely, S. Laying Down Their Rifles: The changing influences on retention of UK Volunteer reservists returning from Iraq. Armed Force and Society 2010: 36: 264-289.

Greenberg N, Langston V, Everitt B, Iversen A, Fear N, Jones N, Wessely S. A cluster randomised controlled trial to determine the efficacy of TRIM (Trauma Risk Management) in a military population. Journal of Traumatic Stress 2010: 23: 430-436
Results of the cluster randomised controlled trial. No differences in primary outcomes between the ships that did or not receive TRIM, but overall there were very few traumatic incidents anyway during the year in question

Langston V, Greenberg N, Fear NT, Iversen AC, French C, Wessely S. Stigma and mental health in the Royal Navy: A mixed methods paper. Journal of Mental Health. 2010;19:8-16.

Horn O, Sloggett A, Ploubidis G, Hull L, Hotopf M, Wessely S, Rona R. Upward trends in symptom reporting in the UK Armed Forces. Eur J Epidemiology 2010: 25-87-94
There is a general increase in symptom reporting across the Armed Forces over a 7 year period, which is independent of deployment

Iversen A, van Staden L, Birtles C, Hacker Hughes J, Browne T, Langston V, Greenberg N, Hotopf M, Rona R, Wessely S,Thornicroft G, Fear N. Help seeking and receipt of treatment in United Kingdom Service Personnel. Br J Psychiatry 2010: 197: 149-155
Padres are more popular than psychiatrists. Informal sources of help are first port of call for service personnel with mental health problems and only the minority are seen in specialist services.

Jones E, Wessely S. British Prisoners-of-War: from resilience to psychological vulnerability, reality or perception. Twentieth Century British History 2010: 21: 163-183

Jones, N. Fear, N.T., Greenberg, N. & Wessely, S. Long Term Occupational Outcomes in Soldiers Who Become Mental Health Casualties When Deployed on Operations. 2010. Psychiatry 2010: 73: 352-364.
Confirms that most of those treated in theatre by the Field Mental Health Teams do well, but less so if they are evacuated back to UK

Mulligan K, Jones N, Woodhead C, Davies M, Wessely S, Greenberg N. Mental Health of UK Military Personnel while on Deployment in Iraq. Br J Psych 2010; 197: 405-410
First ever UK assessment of the mental health of a large group of service personnel in a theatre of war. Showed surprisingly few differences in the prevalence of mental health disorders before, during and after

Pinder, R J.; Fear, NT.; Wessely, S; Reid, G; Greenberg, N. Mental Health Care Provision in the U.K. Armed Forces Military Medicine 2010: 175: 805-810

Rona R, Jones M, Fear N, Hull L, Hotopf M, Wessely S. Alcohol misuse and functional impairment in the UK Armed Forces. Drug and Alcohol Dependence 2010: 108, 37-42
Social and work impairment is acknowledged by those with alcohol dependence, alcohol induced harm or severe alcohol misuse. Those with lower scores of alcohol misuse, but still excessive drinking do not acknowledge impairment.

Sundin J, Fear N, Iversen A, Rona R, Wessely S. PTSD after Iraq: conflicting rates, conflicting claims. Psychological Medicine 2010: 40: 367-382.

Sundin J, Jones N, Greenberg N, Hull L, Rona R, Hotopf M, Wessely S, Fear N. Mental health amongst commando, airborne and other UK infantry personnel. Occupational Medicine 2010: 60: 552-559

Sundin J, Fear NT, Hull L, Jones N, Dandeker C, Hotopf M, Wessely S, Rona RJ. Rewarding and unrewarding aspects of deployment to Iraq and its association with psychological health in UK military personnel. Int Arch Occup Environ Health 2010: 83: 653-663

Frappell-Cooke, W, Gulina, M; Green, K, Hacker Hughes, J, Greenberg, N. Does the use of Trauma Risk Management (TRiM) influence Post-Trauma Reactions of United Kingdom Armed Forces personnel after deployment. Occupational Medicine. 2010.

Buckman J, Sundin J, Greene T, Greenberg N, Fear N, Dandeker C, Wessely S. The impact of deployment length on the health and well being of military personnel: a systematic review of the literature. Occupational & Environmental Medicine 2011: 68: 69-76.

Burdett H, Jones N. Fear N, Wessely S, Greenberg N. Early psychosocial intervention following operational deployment. Analysis of a free text questionnaire response. Military Medicine 2011: 176: 620-625

DuPreez J, Sundin J, Wessely S, Fear NT. Unit cohesion and mental health in UK Armed Forces Personnel.Occ Med 2011: 10: 1-7 Contrary to expectations, soldiers who had trauma related symptoms following their experiences inm Bosnia, neither avoied nor were disturbed by a very powerful dramatic reconstruction of their experiences.

Fernando A, Hull L, Greenberg N, Fear NT, Hotopf M, Wessely S. “Warriors”: Impact of powerful television drama on the psychological health of UK Bosnia peacekeepers. Annals of Epidemiology 2011; 21(9): 660-665

Fertout M, Jones N, Greenberg N, Mulligan K, Knight T, Wessely S. A review of United Kingdom Armed Forces’ approach to prevent post deployment mental health problems. International Review of Psychiatry 2011: 23: 135-143

Greenberg N, Jones E, Jones N, Fear NT and Wessely S. “The Injured Mind in the UK Armed Forces”. Phil Trans Royal Society 2011: 366: 261-267

Greenberg N, Langston V, Iversen A, Wessely. S. The acceptability of a peer group support system “Trauma Risk Management (TRiM)” within the UK Armed Forces. Occupational Medicine, 2011: 61: 184 – 189

Harvey SB, Hatch SL, Jones M, Hull L, Jones N, Greenberg N, Dandeker C, Fear N, Wessely S. Coming home: social functioning and the mental health of UK Reservists on return from deployment to Iraq or Afghanistan. Annals of Epidemiology 2011: 21: 666-672.

Ismail K, Fear N, Flanagan M, Doebbeling B, Wessely, S. Comparison of Symptom Reports, Medical Conditions and Environmental Exposures between US and UK Veterans of the Persian Gulf War 1990-9. Occupational Medicine 2011: 61: 483 – 489

Iversen AC, van Staden L, Hacker Hughes J, Browne T, Langston V, Greenberg N, Hotopf M, Rona RJ, Wessely S, Thornicroft G, Fear NT. Perceived stigma of mental health problems and other barriers to care in the UK Armed Forces. BMC Health Services Research 2011: 11: 31.

Jones, N., Greenberg, N. Burdett, H. & Wessely, S The Subjective Utility of Early Psychosocial Interventions Following Combat Deployment. Occupational Medicine 2011: 61; 102 – 107

Jones, N., Wink, P., Brown, A.B., Berrecloth, D., Abson, E., Doyle, J., Fear, N.T., Wessely, S., and Greenberg, N. A clinical follow up study of reserve forces personnel treated for mental health problems following demobilisation. J Mental Health 2011 : 20: 136-145.

MacManus D, Dean K, Al-Bakir M, Iversen A, Hull L, Wessely S, Fear N. Violent behavior by UK military personnel on returning home after deployment. Psych Med 2011: 10: 1-11
Violent behaviour on homecoming from deployment was associated with premilitary antisocial behaviour as expected, but it was also linked to exposure to combat and traumatic experiences while deployed, even taking into account the earlier link.

MacManus D, Wessely S. Why do some ex-armed forces personnel end up in prison? BMJ 2011: 342: d3898

Mulligan K, Fear NT, Jones N, Wessely S and Greenberg N. Psycho-educational interventions designed to prevent deployment-related psychological ill-health in Armed Forces personnel: a review. Psychological Medicine 2011: 41: 673-686

Pinder R, Boyko E, Gackstetter G, Hooper T, Greenberg N, Murphy D, Ryan M, Smith B, Smith T, Wells T, Wessely S. Profile of Two Cohorts: UK and US Prospective Studies of Military Health. Int J Epidemiology 2011

Pinder R, Iversen A, Kapur N, Wessely S, Fear N. Self harm and attempted suicide in UK Armed Forces Personnel: results of a cross sectional survey. International J Social Psychiatry 2011

Rona RJ, Jones M, Fear NT, Hull L, Murphy D, Machell L, Coker B, Iversen AC, Jones N, David AS, Greenberg N, Hotopf M, Wessely S. Mild Traumatic Brain Injury (mTBI) in the UK military personnel returning from Afghanistan and Iraq. Cohort and cross-sectional analyses. J Head Injury Trauma Rehabilitation 2011: DOI: 10.1097/HTR.0b013e318212f814

Sundin J, Forbes H, Fear N, Dandeker C, Wessely S. The impacts of the conflicts in Iraq and Afghanistan: A UK perspective. Int Review of Psychiatry 2011: 23; 153-159

Sundin J, Fear NT, Wessely S, Rona RJ. Obesity in the UK Armed Forces: Risk Factors. Mil Med 2011: 176; 507-512

Woodhead C, Wessely S. Commentary: what interventions work for victims of conflict related rape? British Medical Journal 2011: 341: 7038

Woodhead C, Rona R, Iversen A, MacManus D, Hotopf M, Dean K, McManus S, Meltzer H, Brugha T, Jenkins R, Wessely S, Fear N. Mental health and service use amongst post-National Service veterans: results from the 2007 Adult Psychiatric Morbidity Survey of England. Psychological Medicine 2011: 41: 363-372
First study to use a population base to compare veterans and non veterans, and in which mental health was ascertained independently of knowledge of service status. No association was found between any mental health outcome, including PTSD, and military service, with the exception of violent behaviour. Females who had served had more suicidal ideation. Early service leavers drank more, and were more likely to have self harmed than longer serving veterans. There was no difference in treatment seeking behaviour between veterans and non veterans

Pinder R, Boyko E, Gackstetter G, Hooper T, Greenberg N, Murphy D, Ryan M, Smith B, Smith T, Wells T, Wessely S. Profile of Two Cohorts: UK and US Prospective Studies of Military Health. Int J Epidemiology. 2011: 1-11

Seddon R, Greenberg N, Jones E, The role of chaplains in maintaining the psychological health of military personnel: an historical and contemporary perspective. Mil Med. 2011.

Woodhead C, Rona R, Iversen A, MacManus D, Hotopf M, Dean K, McManus S, Meltzer H, Brugha T, Jenkins R, Wessely S, Fear N. Health of National Service veterans: An analysis of a community based sample using data from the 2007 Adult Psychiatric Morbidity Survey of England. Soc Psych Psych Epi 2011 : 46: 559-556-0

Murphy D, Marteau T, Wessely S. Longitudinal study of UK personnel offered anthrax vaccination: informed choice, symptom reporting, uptake and pre-vaccination health. Vaccine: 2011: 30: 1088-1094.

Pinder R, Iversen A, Kapur N, Wessely S, Fear N. Self harm and attempted suicide in UK Armed Forces Personnel: results of a cross sectional survey.  International J Social Psychiatry 2012; 58: 433-439

Fertout M, Jones N, Greenberg N. Third location decompression for individual augmentees after a military deployment. Occupational Medicine. 2012: 62: 188-195.

Goodwin L, Jones M, Rona R, Sundin J, Wessely S, Fear N. Prevalence of delayed onset PTSD in military personnel: is there evidence for the disorder? Results of a prospective UK Study. J Nervous Mental Disorder. 2012. 200; 429-437. Yes, there is, and it is more common that we expected.

Jones N, Seddon R, Fear NT, McAllister P, Wessely S &Greenberg N. (2011) Leadership, Cohesion, Morale and the Mental Health of UK Armed Forces in Afghanistan. Psychiatry. 2012. 42; 1663-73

MacManus D, Dean K, Al-Bakir M, Iversen A, Hull L, Wessely S, Fear N. Violent behavior by UK military personnel on returning home after deployment. Psych Med. 2012. 42; 1663-73

MacManus D, Dean K, Iversen A, Hull L, Wessely S, Fear N. Impact of pre-enlistement antisocial behavious on behavioural outcomes among UK military personnel. Sub Social Psych Psych Epi 2012: 47: 1353-1358.
Pre-enlistment conduct problems were associated with negative military behavioural outcomes like alcohol misuse, interpersonal violence, risky driving and irritability and anger.

Mulligan K. Fear N, Jones N, Alvarez H, Hull L, Naumann U, Wessely S, Greenberg N. Post-deployment Battlemind training for the UK Armed Forces: A cluster-randomised controlled trial.
No impact on mental health, and thus failed to replicate the US study, but did find an impact on alcohol. Journal of Consulting and Clinical Psychology. 2012: 80: 331-341

Mulligan K, Jones N Davies M, McAllister P, Fear N, Wessely S, Greenberg N. Effects of Home on the Mental Health of British Forces Serving in Iraq and Afghanistan. Br J Psych. 2012: 201: 193-198

Rona RJ, Jones M, Fear NT, Hull L, Murphy D, Machell L, Coker B, Iversen AC, Jones N, David AS, Greenberg N, Hotopf M, Wessely S. Mild Traumatic Brain Injury (mTBI) in the UK military personnel returning from Afghanistan and Iraq. Cohort and cross-sectional analyses. J Head Injury Trauma Rehabilitation 2012: 27:33-44
The overall prevalence of mTBI was 4%,less than reported by US Forces fighting the same war. The symptoms of what we call post concussional syndrome was largely unrelated to mTBI, suggesting that they are different things.

Rona RJ, Jones M, Fear NT, Sundin J, Hull L, Wessely S. Frequency of mild Traumatic Brain Injury (mTBI) in Iraq and Afghanistan: Are we measuring incidence or prevalence? J Head Injury Trauma Rehab 2012: 27: 75-82
Some, but not all, of the differences between the US and UK is explained by the differences in tour length.

Woodhead C, Wessely S, Jones N , Fear NJ, Hatch S. Impact of exposure to combat during deployment to Iraq and Afghanistan on mental health by gender.Psych Med. 2012: 42: 1985-1996.

Rona R, Jones M, Sundin J, Goodwin L, Hull L, Wessely S, Fear N. Predicting persistent posttraumatic stress disorder (PTSD) in UK military personnel who served in Iraq: A longitudinal study. Journal of Psyhciatric Research 2012: 46: 1191-1198

Sundin J,  Mulligan K, Henry S,  Hull L, Jones N, Greenberg N,  Wessely S, Fear N. Impact on mental health of deploying as an Individual Augmentee in the UK Armed Forces. Mil Med 2012:  177: 511-516

Harvey S  Hatch S, Jones M, Hull L, Jones N, Greenberg N, Danderker C, Fear N,  Wessely S. The long term consequences of military deployment; A 5 year cohort study of UK Reservists deployed to Iraq in 2003.  Am J Epidemiology, 2012.

Fear N, Seddon R, Jones N, Greenberg N, Wessely S. Does anonymity increase the likelihood of participants reporting mental health symptoms? BMC Public Health 2012: 12: 797

Melissa Rowe, Dominic Murphy, Simon Wessely, and Nicola T. Fear. Exploring the Impact of Deployment to Iraq on Relationships. MILITARY BEHAVIORAL HEALTH, 1: 1–9, 2013

Burdett H, Woodhead C, Iversen A, Wessely S, Dandeker C, Fear N. “ Are you a veteran? “  What do ex service personnel understand by the term?  Armed Forces & Society 2013: 39: 751-759

Jones N, Jones M, Fear NT, Fertout M, Wessely S, Greenberg N. Can mental health and readjustment be improved in UK military personnel by a brief period of structured postdeployment rest (third location decompression)? Occup Environ Med 2013;0:1–7.

MacManus D,  Dean K,  Jones M, Rona R, Greenberg N, Hull L, Fahy T, Wessely S, Fear N.  Violent offending amongst UK military personnel deployed to Iraq and Afghanistan: A criminal record linkage study. Lancet 2013: 381:907-917

Hatch S , Harvey S, Dandeker C, Burdett H, Jones M ,Wessely S.  Life in and after the Armed Forces: Social Networks and the Mental Health of Service Leavers in the UK. Sociology of Health and Illness. 2013: 35: 1045-1064

Rona R, Jones M,Goodwin L, Hull L, Wessely S. Risk factors for headache in the UK military: cross-sectional and longitudinal analyses.  Headache 2013: 53: 787-798

Goodwin L, Fear N, Bourke J, Hotopf M, Nijjar R, Hull L, Rona R, Wessely S.  Irritable bowel syndrome in the UK military after deployment to Iraq: what are the risk factors?  Social Psychiatry Psych Epidemiology 2013: 48;1755-1765

Forbes H,  Boyd C, Jones N, Greenberg N, Jones E, Wessely S, Iversen A, Fear N. Attitudes to mental illness in the UK Armed Forces: a comparison with the general population.  Mil Med 2013: 176: 957-965

Hinds L, Jawahar K, Wessely S, Fear N.  Self harm in the UK military. Occ Med 2013: 63: 354-35

Buckman J, Forbes H, Clayton T, Jones M, Jones N, Greenberg N, Sundin J, Hull L, Wessely S, Fear NT. Early Service leavers: a study of the factors associated with premature separation from the UK Armed Forces and the mental health of those that leave early. European Journal of Public Health. In Press.

Jones, N, Thandi G, Fear NT, Wessely S, Greenberg N. The psychological effects of improvised explosive devices (IEDs) on UK military personnel in Afghanistan.  Occup Environ Med 2013

J Holmes, N T Fear, K Harrison, J Sharpley, S Wessely. Suicide among Falkland war veterans. Responses should be based on sound statistics not misleading sound bites. BMJ 2013;346:f3204 doi: 10.1136/bmj.f3204

Jones M, Sundin J, Goodwin L, Hull L, Fear N,  Wessely S, Rona R. What explains Posttraumatic Stress Disorder (PTSD) in UK Service Personnel?  Deployment or something else? Psychological Medicine 2013;43: 1703-1712


MacManus D, Jones N, Wessely S, Fear NT, Jones E, Greenberg N. The mental health of the UK Armed Forces in the 21st century: resilience in the face of adversity. J R Army Med Corps 2014: Vol 160, Issue 1

Debell F, Fear N, Head M, Batt-Rawden S, Greenberg N, Wessely S, Goodwin L. A systematic review of the comorbidity between PTSD and alcohol misuse. Social Psychiatry and Psychiatric Epidemiology 2014: DOI 10.1007/s00127-014-0855-7

Gribble R, Wessely S, Klein S, Alexander D, Dandeker C, Fear N. Public awareness of UK veterans’ charities.  RUSI Journal 2014;159:50-57

Gribble R, Wessely S, Klein S, Alexander D, Dandeker C, Fear NT. British Public Opinion after a Decade of War: Attitudes to Iraq and Afghanistan. Political Studies Association: 2014

Jones N, Mitchell P, Clack J, Fertout M, Fear NT, Wessely S and Greenberg N.  Mental health and psychological support amongst UK armed forces personnel deployed to Afghanistan in 2010 and 2011 . Br J Psychiatry 2014: 204: 157-162

Sundin J, Herrell R, Hoge C, Fear N, Adler A, Greenberg N, Riviere L, Thomas J, Wessely S, Bliese P. Mental health outcomes in US and UK Military personnel returning from Iraq. Br J Psych 2014 : 204: 200-207

L. Goodwin, S. Wessely, M. Hotopf, M. Jones1, N. Greenberg, R. J. Rona, L. Hull,  N. T. Fear. Are common mental disorders more prevalent in the UK serving military compared to the general working population? Psychological Medicine 2014

Hines L, Gribble R, Wessely S, Dandeker C, Fear NT. Are the Armed Forces Understood and Supported by the Public? A View from the United Kingdom. Armed Forces & Society. 1-26. 2014

Jones, E, Wessely, S. Battle for the mind: The First World  War and the birth of military psychiatry. The Lancet 2014 : 384: 1708 – 1714

Roberto J Rona, Margaret Jones, Mary Keeling, Lisa Hull, Simon Wessely, Nicola T Fear Mental health consequences of overstretch in the UK Armed
Forces, 2007–09: a population-based cohort study. Lancet  Psychiatry 2014: 1: 531-538

Rowe S, Keeling M, Fear N, Wessely S. Perceptions of the impact of a military career has on children.  Occupational Medicine 2014 64: 490-496

Hines L, Sundin J, Rona R, Wessely S, Fear N. Posttraumatic stress disorder post Iraq and Afghanistan: Prevalence among Military Subgroups.  Canadian J Psychiatry 2104: 59:468-479

Dazzi T, Gribble R, Wessely S, Fear NT (2014). Does asking about suicide and related behaviours induce suicidal ideation? What is the evidence? Psychol Med. 2014 Jul 7:1-3.

Jones, N., Fear, N.T., Rona, R., Fertout, M., Thandi, G., Wessely, S. Greenberg, N.Mild traumatic brain injury (mTBI) among UK military personnel whilst deployed in Afghanistan in 2011. Brain Injury; doi: 10.310902699052.2014.888479. 2014

Hunt, E.J.F, Wessely, S., Jones, N., Rona, R.J. Greenberg, N. The mental health of the UK Armed Forces: where facts meet fiction. http:dx.doi.org10.3402ejpt.v5.23617. 2014

Jones E, Wessely S.  Battle for the Mind: the  First World War and the birth of military psychiatry.  Lancet 2014 : 384: 1708-1714


Mary Keeling, Simon Wessely, Christopher Dandeker, Norman Jones & Nicola T. Fear Relationship Difficulties Among UK Military Personnel: The Impact of Socio-Demographic, Military and Deployment-Related Factors. Routledge 2015.

Gould M, Meek D, Gibbs D, Sawford H, Wessely S, Greenberg N. What are the psychological effects of delivering and receiving “high risk” survival training?  Military Medicine 2015; 180; 168-177

Cawkill, P., Jones, M., Fear, NT., Jones, N., Fertout, M., Knight, T., Wessely S, Greenberg, N. The mental health of UK Armed Forces medical personnel post deployment Occupational Medicine. 2015: 65;157-164

Sharp M, Rona R, Greenberg N, Jones N, Goodwin L, Wessely S, Fear N. Stigma as a barrier to seeking healthcare among military personnel with mental health problems.  Epidemiologic Reviews. 2015; 144-162.

Rona, R. J., Jones, M., Hull, L., MacManus, D., Fear, N. T., Wessely, S. (2015). Anger in the UK Armed Forces: Strong Association With Mental Health, Childhood Antisocial Behavior, and Combat Role. The Journal of nervous and mental disease, 203(1), 15-22. 2015

Murphy, Dominic, et al. “Mental health and functional impairment outcomes following a 6-week intensive treatment programme for UK military veterans with post-traumatic stress disorder (PTSD): a naturalistic study to explore dropout and health outcomes at follow-up.” BMJ open 5.3 (2015): e007051.

Greenberg. N, Wessely. S, Wykes. T Potential mental health consequences for workers in the Ebola regions of West Africa a lesson for all challenging environments. J Ment Health, 2015; 24(1): 13 DOI: 10.310909638237.2014.1000676

Fear, Nicola T., and Simon Wessely. “Prevention of the psychological consequences of trauma.” The Lancet Psychiatry (2015).

MacManus, Deirdre,  et al. “Aggressive and violent behavior among military personnel deployed to Iraq and Afghanistan: prevalence and link with deployment and combat exposure.” Epidemiologic reviews 37.1 (2015): 196-212.

MacManus, Deirdre, et al. “Former Armed Forces personnel in the Criminal Justice System.” The Lancet Psychiatry. 2015

Thandi G, Sundin J, Dandeker C, Jones N, Wessely S, Fear N.Risk-Taking Behaviours among UK military reservists. Occupational Medicine 2015: 65; 413-416.

Goodwin L, Wessely S, Fear NT. The Future of “Big Data” in Suicide Behaviors Research: Can We Compare the Experiences of the U.S. and U.K. Armed Forces? Psychiatry. 2015;78(1):25-8.


Head, M, Goodwin, L, Debell, F, Greenberg, N, Wessely, S. Post-traumatic Stress Disorder and Alcohol Misuse: Comorbidity in UK Military Personnel. Soc Psychaitr Epidemiol. 2016: 52; 1-10.

Greenberg, N, Bull A, Wessely S. Chilcot: physical and mental legacy of Iraq war on UK service personnel. BMJ 2016; 354 doi:

Murphy, D, Spencer-Harper, L, Carson, C, Palmer, E, Hill, K, Sorfleet, N, Wessely, S, Busuttil, W. Long-term responses to treatment in UK veterans with military-related PTSD: an observational study. BMJ Open 2016; 6

Rona R, Burdett H, Bull S, Jones M, Jones N, Greenberg N, Wessely S, Fear N.  Prevalence of PTSD and other mental disorders in UK Service personnel by time since end of deployment: a meta-analysis.  BMC Psychiatry 2016; 16: 333

Jones, N, Fear NT, Wessely, S, Thandi G, Greenberg N. Forward psychiatry – early intervention for mental health problems among UK armed forces in Afghanistan. European Psychiatry 39: 2016; 66-72


Rona R, Burdett H, Khondoker M, Chesnikov M, Green K, Pernet D, Jones  N, Greenberg N, Wessely S, Fear N. The effectiveness of post deployment screening for mental disorder and the impact of tailored advice about help seeking in the UK military: a cluster randomized controlled trial. Lancet published Online February 16, 2017 S0140-6736(16)32398-4

Chris R. Brewin, Marylène Cloitre, Philip Hyland, Mark Shevlin, Andreas Maercker ,Richard A. Bryant , Asma Humayun, Lynne M. Jones, Ashraf Kagee, Cécile Rousseau ,Daya Somasundaram, Yuriko Suzuki, Simon Wessely, Mark van Ommeren, Geoffrey M. Reed. A review of current evidence regarding the ICD-11 proposals for diagnosing PTSD and complex PTSD. Clinical Psychology Review Volume 58, December 2017, Pages 1-15.

Fear N, Meek D, Cawkill P, Jones N, Greenberg N, Wessely S.  The health of UK civilians deployed to Iraq. Eur J Public Health 2017; 27;367-371

Osorio, C., Jones, N., Jones, E., Robbins, I., Wessely, S., Greenberg, N. (2018). Combat experiences and their relationship to post-traumatic stress disorder symptom clusters in UK military personnel deployed to Afghanistan. Behavioral Medicine, 44 (2), 131-140

Greenberg, N., Wessely, S. (2017). Mental health interventions for people involved in disasters: what not to do. World Psychiatry, 16 (3), 249-250

Mahar, A.L., Gribble, R., Aiken, A.B., Dandeker, C., Duffy, B., Gottfried, G., Wessely, S., Fear, N.T. Public opinion of the Armed Forces in Canada, U.K. and the U.S.

Jones, N., Fear, N.T., Wessely, S., Thandi, G., Greenberg, N. (2018). The long term occupational fitness of UK military personnel following community mental health care. Journal of Mental Health, 27 (2), 142-149

Goodwin, L., Norton, S., Fear, N.T., Jones, M., Hull, L., Wessely, S., Rona, R.J. (2017). Trajectories of alcohol use in the UK military and associations with mental health. Addictive Behaviors, 75, 130-137


Leightley, D., Chui, Z., Jones, M., Landau, S., McCrone, P., Hayes, R.D., Wessely, S., Fear, N.T., Goodwin, L. Integrating electronic healthcare records of armed forces personnel: Developing a framework for evaluating health outcomes in England, Scotland and Wales (2018) International Journal of Medical Informatics, 113, pp. 17-25.

Nicola T. Fear, Ruth V. Reed, Sarah Rowe, Howard Burdett, David Pernet, Alyson Mahar, Amy C. Iversen, Paul Ramchandani, Alan Stein and Simon Wessely. Impact of paternal deployment to the conflicts in Iraq and Afghanistan and paternal post-traumatic stress disorder on the children of military fathers. The British Journal of Psychiatry (2018) Pages 1 – 9. doi: 10.1192/bjp.2017.16

Morris-Butler, R; Jones, N; Greenberg, N; Campion, B; Wessely, S Experiences and career intentions of combat-deployed UK military personnel. Occupational Medicine 2018: 68;177-183

Stevelink S, Jones M, Hull L, Pernet D, MacCommon S, Goodwin L, Murphy D, Jones N, Greenberg N, Rona R, Fear N, Wessely S. Mental health outcomes at the end of the British involvement in the Iraq and Afghanistan conflicts: A cohort study.  Br J Psychiatry 2018, doi: 10.1192/bjp.2018.175

2019 and In Press

Laura Palmera,1, Gursimran Thandia,1, Sam Norton, Margaret Jones, Nicola T. Fear, Simon Wessely, Roberto J. Rona. Fourteen-year trajectories of posttraumatic stress disorder (PTSD) symptoms in UK military personnel, and associated risk factors. Journal of Psychiatric Research Volume 109, February 2019, Pages 156-163

Rona R, Jones M, Jones N, Fear N, Wessely S. Long term correlates of mild traumatic brain injury (mTBI) on post concessional symptoms after deployment to Iraq and Afghanistan in the UK Military. J Head Trauma & Rehabilitation 2019

Norman Jones, Neil Greenberg, Ava Phillips, Amos Simms & Simon Wessely (2019): Mental Health, Help-Seeking Behaviour and Social Support in the UK Armed Forces by Gender, Psychiatry, DOI: 10.1080/00332747.2019.1626200

Osumili, B., McCrone, P., Burdett, H., Jones, N., Fear, N. T., Wessely, S., Rona, R. J. (2019). Cost of post-deployment screening for mental illness in the UK military: findings from a cluster randomised controlled trial. Journal of Mental Health, 1-8.

Stevelink, S.A.M.; Jones, N.; Jones, M.; Dyball, D.; Khera, C.K.; Pernet, D.; MacCrimmon, S.; Murphy, D.; Hull, L.; Greenberg, N.; MacManus, D.; Goodwin, L.; Sharp, M.; Wessely, S.; Rona R.J. and Fear, N.T. (2019). Do serving and ex-serving personnel of the UK armed forces seek help for perceived stress, emotional or mental health problems?. European Journal of Psychotraumatology, 10 (1), 1556552.

David Forbes, David Pedlar, Amy B. Adler, Clare Bennett, Richard Bryant, Walter Busuttil, John Cooper, Mark C. Creamer, Nicola T. Fear, Neil Greenberg, Alexandra Heber, Mark Hinton, Mal Hopwood, Rakesh Jetly, Ellie Lawrence-Wood, Alexander McFarlane, Olivia Metcalf, Meaghan ODonnell, Andrea Phelps, J. Don Richardson, Nicole Sadler, Paula P. Schnurr, Marie-Louise Sharp, James M. Thompson, Robert J. Ursano, Miranda Van Hooff, Darryl Wade Simon Wessely (2019): Treatment of military-related post-traumatic stress disorder: challenges, innovations, and the way forward, International Review of Psychiatry, DOI: 10.108009540261.2019.1595545

Murphy D, Shelvin M, Pearson E, Greenberg N, Wessely S, Busittil W, Karatzsas R, A validation study of the International Trauma Questionnaire to assess post traumatic stress disorder in treatment seeking veterans. Br J Psychiatry 2020; 216: 132-137

Bricknell MC, Williamson V, Wessely S, Understanding military combat mental health, Occupational Medicine, Volume 70, Issue 4, June 2020: 216–218,

Victoria Williamson, D Murphy, S A M Stevelink, E Jones, S Wessely, N Greenberg. Confidentiality and psychological treatment of moral injury: the elephant in the room. BMJ Mil Health. 2020

For other publications relating to military health refer to this website: KCMHR and ADMMH publications