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Screening for Psychological Illness in the Military—Reply
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In Reply: Although it is true that the study by Dr Wright and colleagues1 did not provide sensitivity and specificity, it did provide information on true positives, true negatives, false positives, and false negatives for multiple psychological problems from which these were calculated. Of those soldiers who were true positives, 45% required immediate referral but were assessed as deployable, 48% were assessed as subclinical (indicating a moderate amount of distress not requiring a referral), and 4% were already receiving treatment. Thus, the great majority were able to function without clear indication of need of treatment.
Dr Wright and colleagues also state that in the studies by Bliese et al,2-3 the prevalence of mental health problems was low, but that rates increased in a follow-up 120 days later. We did not have access to the new report until after our Commentary was published. In this report, they reduced sensitivity in order . . . [Full Text of this Article]
Simon Wessely, MD
s.wessely@iop.kcl.ac.uk
King’s Centre for Military Health Research
King’s College
London, England
Kenneth C. Hyams, MD
Office of Public Health and Environmental Affairs
Department of Veterans Administration
Washington, DC
Roberto J. Rona, FFPH
Department of Public Health Sciences
King’s College
London, England
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