"Forward psychiatry" in the military: Its origins and effectiveness
"Forward psychiatry" in the military: Its origins and effectiveness
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DOI：
10.1023/a:1024426321072
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发表时间：
2003-08-01
影响因子：
3.3
通讯作者：
Wessely, S
中科院分区：
文献类型：
--
作者：
Jones, E;Wessely, S
“前沿精神病学”是在第一次世界大战中为治疗炮弹休克而设计的，今天是战斗应激反应的标准干预措施。它依赖于三个原则：接近战斗，即时性，以及恢复的预期，随后给出了首字母缩略词“PIE”。“美国和英国军队在第二次世界大战期间都迟来地重新引入了PIE方法，以使军人重返现役，并对其功效提出了自信的要求。在朝鲜战争和越南战争期间，先进的治疗单位似乎也最大限度地减少了精神病患者的伤亡。对以色列部队在黎巴嫩冲突中使用该系统的情况进行的评价表明，其返回岗位率高于基地医院。对这些例子的重新检查表明，报告的结果往往夸大了它作为急性应激反应治疗和慢性疾病（如PTSD）预防的有效性。目前还不清楚干预行动是为谁服务：是为士兵个人还是为军队的需要服务。
"Forward psychiatry" was devised in World War I for the treatment of shell shock and today is the standard intervention for combat stress reaction. It relied on three principles: proximity to battle, immediacy, and expectation of recovery, subsequently given the acronym "PIE." Both US and UK forces belatedly reintroduced PIE methods during World War II to return servicemen to active duty and made confident claims for its efficacy. Advanced treatment units also appeared to have minimized psychiatric battle casualties during Korean and Vietnamese Wars. Evaluations of its use by Israeli forces in the Lebanon conflict showed higher return-to-duty rates than at base hospitals. A reexamination of these examples suggests that reported outcomes tended to exaggerate its effectiveness both as a treatment for acute stress reaction and as a prophylaxis for chronic disorders such as PTSD. It remains uncertain who is being served by the intervention: whether it is the individual soldier or the needs of the military.