Deployment-related stress disorder in german soldiers: utilization of psychiatric and psychotherapeutic treatment

Abstract

Introduction: Military missions abroad carry a high risk of psychological traumatization. In this study, we examined the reasons for increased utilization of the treatments offered to soldiers by the German armed forces' psychiatric services.

Method: We analyzed trends in initial contacts with psychiatrists and psychotherapists among German soldiers participating in missions to Afghanistan and the Balkans. To this end, we evaluated existing data from the psychiatric services of all German Armed Forces Military Hospitals with respect to sociodemographic factors (sex, area of mission) and the underlying psychiatric disorders over an 18-month period (January 2010 to June 2011).

Results: 615 soldiers made an initial contact with the psychiatric and psychotherapeutic services during the study period. The total number of first contacts did not change significantly (p = 0.195), but there was a notable rise in the number of first contacts by female soldiers with deployment-related stress (p = 0.003). Mission-specific statistics revealed a significant increase in the number of first contacts only for soldiers deployed to the Balkans (p = 0.017). 91% of soldiers making a first contact were given the diagnosis of a stress reaction (ICD-10: F 43); the second most common diagnosis (8.9%) was an affective disorder (ICD-10: F 32.0, F 32.1).

Conclusion: Despite psychological prevention efforts, military missions abroad often lead to mental disorders. Our findings indicate that the mild observed increase in incidence is both sex-specific and deployment-area-specific.

Figure 1

Psychiatric-psychotherapeutic first-time and follow-up contacts (utilization) in months in the time period January 2010 through June 2011. Owing to the introduction of a systematic data collection system in January 2010 we start at the zero level (German soldiers deployed in Afghanistan since the start of the missions n = 812 89, in the Balkans n = 170 554. The numbers given here relate to the totals in both deployments).

Figure 2

Time interval (latency period) between the traumatic event and initial symptom onset (latency period between trauma and symptom) and between the first onset of symptoms and first contact to a medical specialist (latency period between symptom and contact) in months, January 2010 through June 2011

Figure 3

Graphical representation of the regression analysis in the regressors deployment region and female soldiers