20 de enero de 2007

Razones psiquiátricas para no ser activados los reservistas

                               Psychiatric/Psychological Reports for Recalled Iraq War Vets


                                    Functional Capacity Certification (Standard Form 507)


This form is included in the packet ordering vets back into the military and must be filled out and faxed immediately to delay the reactivation order. 60 days delay may be given.


Veterans fill out the top part and a physician fills out the bottom. The veteran should note any physical injury on the form that would impair their mobility. If they have been treated for psychiatric problems they should include this as well. On the bottom is a physician's statement. The diagnosis of Post Traumatic Stress Disorder (PTSD) and either Bipolar Affective Disorder (BAD) or Major Depression with Psychotic features should provide a temporary delay to returning to participating in the Iraq War again. This form must be signed by a physician. A primary care physician can sign this form.  Psychosis and Bipolar Affective Disorder are considered exclusionary conditions for returning to fight in the Iraq War. Post Traumatic Stress is not an exclusionary diagnosis. The only psychiatric medications that are exclusionary are mood stabilizers such as lithium and valproic acid or antipsychotic medications. The military prohibits any comment on the recommendation that an individual not fight in the Iraq War.


                                          Psychiatric or Psychological Evaluation

A comprehensive psychiatric or psychological report should follow the Functional Capacity Certificate. This document is the medical report that supports the diagnosis of PTSD and a second psychiatric condition such as Bipolar Affective Disorder or Major Depression with Psychotic features. BAD should include symptoms of mania or hypomania with irritability, excessive activity in spending, not sleeping, increased sex. Major Depression with Psychotic Features is depression with hopelessness, not eating, poor appetite. Psychotic features could include paranoia or delusions, beliefs that are not based on reality. Psychotic features can also be hallucinations, visual or auditory. Vivid flashbacks can sometimes be described as hallucinations. If depression is present, does the individual have thoughts of not wanting to be alive? Has he/she had thoughts of doing something to hurt him/herself? What type of thoughts? If any of these features are present this person is suicidal. Documentation of suicidal ideation is crucial. Wishing that you are not alive is passive suicidal ideation which requires further exploration. Suicidal individuals are not desired back the Iraq War. If homicidal ideation is present this also should be noted.


This document should be written by a mental health professional such as psychiatrist, psychologist, psychiatric social worker, licensed counselor, psychiatric nurse or clinical nurse specialist. It can be a private, community, VA or military mental health person. The severity of psychiatric problems should not be minimized. Since many military or VA mental health practitioners may be wary of doing this it might be wise and quicker to go a private mental health professional. If Panic Disorder, Generalized Anxiety, Agoraphobia, Sleep Disorder such as Sleep Terror or Obstructive Sleep Apnea are present, put these in the report as well, but it is best to have just two or three diagnosis.  The following format should be used:


History of Present Illness:

Past History:

Mental Status Examination:


Discussion of seriousness of disorders:

SI alguna persona nos puede ayudar a traducir este texto, comuníquese a madrescontralaguerra@gmail.com. MCG