うつ病と不安に関するジャーナル
オープンアクセス

概要

Rates of Mental Disorders Among German Soldiers Deployed to Afghanistan: Increased Risk of PTSD or of Mental Disorders In General?

Hans-Ulrich Wittchen, Sabine Schönfeld, Clemens Kirschbaum, Sebastian Trautmann, Christin Thurau, Jens Siegert, Michael Höfler, Robin Hauffa and Peter Zimmermann

Background: Controversy exists regarding the prevalence of military mission-related PTSD and other mental disorders among deployed soldiers.

Methods: Based on a random stratified sample of n=1599 German soldiers (response rate (RR) 93%, n=1483), we assessed subjects 12 months after  deployment to Afghanistan and compared findings to controls of n=932 never deployed soldiers (RR: 95%, n=889). Interviews were conducted by trained  non-military clinical interviewers using the DSM-IV-TR-Composite International Diagnostic Interview  (CIDI-military). Outcome measures were 12-month prevalence and incidence of PTSD, anxiety,  depressive, substance use disorders and other DSM-IV-TR mental disorders.

Results: Deployed soldiers reported high rates of combat-related and other traumatic events. Compared to controls they had a higher 12-month incidence (OR: 4.3) and prevalence (OR: 2.4) of PTSD, anxiety (OR: 3.6, 1.4), and alcohol use disorders (OR: 3.5, 1.9). They also had higher rates of multiple diagnoses (MR: 1.72) and higher anxiety distress scores. Incidence of PTSD and other mental disorders were best predicted by prior lifetime mental disorders.

Conclusions: German soldiers deployed to Afghanistan are at increased risk of traumatic events and of mental disorders including PTSD as compared to never-deployed soldiers. The risk for other mental disorders subsequent to traumatic events such as anxiety, somatoform, and alcohol use disorders was substantially larger than the risk for PTSD. Prior mental disorders were found to be the strongest predictor of 12-month mental disorders and suggest that pre-mission psychopathological screening might be crucial to reduce mission-related mental health risks.