Since September 11 2001, or "9/11", approximately 2.7 US million service members have served in the wars in Afghanistan and Iraq. Many thousands have been wounded, with injuries ranging from mild to severe. PTSD (post traumatic stress disorder) and TBI (traumatic brain injury) have been called the "signature wounds" of war. The psychological injuries of war, PTSD and related co-morbid conditions, lead to feeling isolated from others, which directly affects intimate relationships. TBI (traumatic brain injury) is also a very common injury from these past decades of war. The treatment of PTSD and TBI involves medications that often have sexual side-effects, such as erectile dysfunction and loss of libido, weight gain, ejaculatory delay, and sedation. The bomb blast has been the "signature weapon" of these conflicts. Service members wear helmets and body armor, which covers their torsos. Thus blasts primarily effect the lower exposed areas of the body, including the extremities and pelvic region. Numerous service members have lost one or both legs, and in some cases arms. Because of the blast, many have lost part or all of their genitalia, their penis or testes. This loss directly impacts sexual functioning and fertility. The bomb blast or other weapons may also burn and scar faces and hands. Pain from these injuries and subsequent surgeries is a constant theme. Sexual difficulties contribute to relationship difficulties, domestic violence, and suicide. Less well recognized is the impact of toxic exposures on sexual health. All wars are environmentally dirty. Agent Orange is the best known toxic agent from Vietnam. Anti-malarial agents, used in Iraq and Afghanistan, cause a host of neuropsychiatric effects. Sexual assault is another type of toxic exposure. Thus there are a host of ways that exposure to combat can affect intimacy, sexual functioning and fertility. Fortunately there are many strategies to mitigate these negative effects, which are covered in detail in this book.

In the very first text of its kind, Women at War brings together all the available information and experience on Women's health and mental health under one cover to enlighten the practitioners caring for them. 2.5 million US service members have deployed since September 11th, 2001 to the wars in Iraq and Afghanistan; with over 300,000 of these soldiers being women. While the available information on the medical and mental health needs of women in deployment and combat is sparse and hard to find, this new volume brings together the literature that exists on female active duty service members and veterans. Women at War reviews topics such as epidemiology, deployment health, reproductive and genitourinary issues, mothering, sexuality, PTSD and other psychological effects of war, wounds and disability, intimate partner violence, sexual assault and suicide. It provides health care providers with insight that can help treat and prevent illness in the female military population by bringing together researchers, clinicians and service member experience and knowledge and presents the information in a practical, actionable format. It also highlights areas where data is lacking and more study is demanded.

This volume highlights the socioeconomic concerns related to medical care for homeless patients and places them at the interface of common psychiatric and medical problems clinicians encounter. Written by experts in psychiatry and other medical specialties, this volume is a concise, yet comprehensive overview of the homeless crisis, its costs, and ultimately, best practices for improved outcomes. The text begins by examining the scope and epidemiology of the problem and discusses its costs. It then examines the best practices for both physical and psychiatric care before concluding with a section on working with special populations that have unique concerns across the country including LGBTQ, women, children, veterans, and aging adults. As the first medical book on homelessness, it is designed to cover a broad range of concerns in a concise, practical fashion for all clinicians working with homeless patients. Clinical Management of the Homeless Patient is written by and for psychiatrists, general internists, geriatricians, pediatricians, addiction medicine physicians, VA physicians, and all others who may encounter this crisis in their work.

This volume tells the history of homosexuality in the United States military beginning in 1986, when the issue first came to the forefront of social consciousness. Each chapter is written through the eyes of gay mental healthcare providers, covering how to steadily adapt and learn to treat veterans struggling with the traumas associated with the stigma of homosexuality in service. Topics include the "Don't-Ask-Don't-Tell" (DADT) policy, its repeal in 2011, and addresses the current trends and challenges. Unlike any other professional book, this text includes the personal stories of gay military mental healthcare providers, as well as gay civilian clinicians who have worked with the military population in various segments in history. These accounts offer invaluable support for medical professionals working with this demographic. Chapters cover the various psychological damage service personnel encounter as it uniquely pertains to those struggling with the stigma of LGBTQ rights. Chapters include clinical pearls for particular psychiatric concerns, lessons learned for the future, and hard-earned successes as stigmas and perceptions evolved over time. Gay Mental Healthcare Providers and Patients in the Military is an excellent resource for psychiatrists, psychologists, social workers, policymakers, and all professionals who are interested in LGBTQ rights in the context of veteran psychiatry.

This book tells the professional and personal experiences of American military psychiatrists and their colleagues in the longest conflict in American history. These highly trained men and women treat service members for the psychological consequences from their experiences in battle, including killing enemy combatants; seeing wounded and killed civilian casualties; losing their friends in combat; factoring in personal mental health needs, including psychiatric drug treatment; and potentially dealing with their own physical injuries from being shot or blown up. The volume consists of 20 short first-person case studies from the mental health providers who have been risking their lives while treating patients in the battlefield since 9/11. Written by expert psychiatrists who have experienced these challenges directly, this texts offers both a clinical and personal account that is not found anywhere else. Topics include tips on providing psychotherapy in battle, evaluating and treating detainees in war prisons such as Abu Ghraib and Guantanamo Bay, and the unique challenges of prescribing medication to patients who are also comrades in war. Psychiatrists in Combat is uniquely positioned to be a valuable resource for psychiatrists interested in trauma and veterans, psychologists, social workers, occupational therapists, military health personnel, and mental health professionals interested in military psychiatry.

This book takes a case-based approach to addressing the challenges psychiatrists and other clinicians face when working with American combat veterans after their return from a war zone. Written by experts, the book concentrates on a wide variety of concerns associated with posttraumatic stress disorder (PTSD), including different treatments of PTSD. The text also looks at PTSD comorbidities, such as depression and traumatic brain injury (TBI) and other conditions masquerading as PTSD. Finally, the authors touch on other subjects concerning returning veterans, including pain, disability, facing the end of a career, sleep problems , suicidal thoughts, violence, , and mefloquine "toxidrome". Each case study includes a case presentation, diagnosis and assessment, treatment and management, outcome and case resolution, and clinical pearls and pitfalls. Post-Traumatic Stress Disorder and Related Diseases in Combat Veterans is a valuable resource for civilian and military mental health practitioners, and primary care physicians on how to treat patients returning from active war zones.

Bringing together over 40 leading experts in disaster mental health, this essential volume presents practical clinical guidelines grounded in the best science available. The focus is on what first-responders, clinicians, and policymakers need to know about effective intervention in the immediate, intermediate, and long-term aftermath of large-scale traumatic events. Vital lessons learned from a variety of mass traumas and natural disasters are incorporated into this book's thorough review of strategies for helping specific victim and survivor populations. Of crucial importance, the authors clearly summarize the empirical evidence supporting each intervention and provide other guidance based on experience and consensus recommendations.