title: Deployment-related stress disorder in german soldiers: utilization of psychiatric and psychotherapeutic treatment.
abstract: BACKGROUND
  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.
  
  
  METHODS
  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).
  
  
  CONCLUSIONS
  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.
authors.affiliation: Center of Military Mental Health, Berlin, Germany.
authors.forename: Jens T
authors.initials: JT
authors.lastname: Kowalski
authors.forename: Robin
authors.initials: R
authors.lastname: Hauffa
authors.forename: Herbert
authors.initials: H
authors.lastname: Jacobs
authors.forename: Helge
authors.initials: H
authors.lastname: Höllmer
authors.forename: Wolf Dieter
authors.initials: WD
authors.lastname: Gerber
authors.forename: Peter
authors.initials: P
authors.lastname: Zimmermann
mesh_terms: D000328:Adult; D055826:Afghan Campaign 2001-; D063368:Balkan Peninsula; D003130:Combat Disorders / Q000453:epidemiology* / Q000628:therapy*; D005260:Female; D005858:Germany / Q000453:epidemiology; D006801:Humans; D008297:Male; D008875:Middle Aged; D008889:Military Personnel / Q000706:statistics & numerical data*; D009784:Occupational Diseases / Q000453:epidemiology / Q000628:therapy; D015995:Prevalence; D011613:Psychotherapy / Q000706:statistics & numerical data*; D012307:Risk Factors; D013313:Stress Disorders, Post-Traumatic / Q000453:epidemiology* / Q000628:therapy*; D014195:Travel / Q000706:statistics & numerical data*; D055815:Young Adult