title: The effect of deployment to a combat zone on testosterone levels and the association with the development of posttraumatic stress symptoms: A longitudinal prospective Dutch military cohort study.
abstract: OBJECTIVE
  There is limited evidence on the association of the activity of HPG-axis with stress and symptoms of stress-related disorders. The aim of the current study was to assess the effect of deployment to a combat zone on plasma testosterone levels, and the possible association with the development of symptoms of posttraumatic stress disorder (PTSD).
  
  
  METHODS
  A total of 918 males were included in the study before deployment to a combat zone in Afghanistan. The effect of deployment on testosterone was longitudinally assessed; starting prior to deployment and follow-up assessments were preformed at 1 and 6 months after return. Furthermore, the association with PTSD symptoms reported at 1 and 2 years post-deployment was assessed.
  
  
  RESULTS
  Plasma testosterone levels were significantly increased after deployment compared with pre-deployment levels. Although no difference was found between individuals reporting high or low levels of PTSD symptoms, pre-deployment testosterone levels predicted the development of PTSD symptoms at 1 and 2 years post-deployment.
  
  
  CONCLUSIONS
  This study provides evidence that not the alterations in testosterone levels shortly after deployment, but the pre-deployment testosterone levels are associated with PTSD symptoms, which is of value in the identification of biological vulnerability factors for the development of PTSD.
authors.affiliation: Research Centre-Military Mental Healthcare, Ministry of Defence, Utrecht, The Netherlands; Brain Center Rudolf Magnus, Department of Psychiatry, University Medical Center Utrecht, Utrecht, The Netherlands; Department of Psychiatry, Leiden University Medical Center, Leiden, The Netherlands. Electronic address: A.Reijnen@umcutrecht.nl.
authors.forename: Alieke
authors.initials: A
authors.lastname: Reijnen
authors.affiliation: Research Centre-Military Mental Healthcare, Ministry of Defence, Utrecht, The Netherlands; Brain Center Rudolf Magnus, Department of Psychiatry, University Medical Center Utrecht, Utrecht, The Netherlands.
authors.forename: Elbert
authors.initials: E
authors.lastname: Geuze
authors.affiliation: Research Centre-Military Mental Healthcare, Ministry of Defence, Utrecht, The Netherlands; Brain Center Rudolf Magnus, Department of Psychiatry, University Medical Center Utrecht, Utrecht, The Netherlands; Department of Psychiatry, Leiden University Medical Center, Leiden, The Netherlands; Arq, Psychotrauma Expert Group, Diemen, The Netherlands.
authors.forename: Eric
authors.initials: E
authors.lastname: Vermetten
mesh_terms: D000328:Adult; D055826:Afghan Campaign 2001-; D006801:Humans; D008137:Longitudinal Studies; D008297:Male; D008889:Military Personnel; D009426:Netherlands; D011446:Prospective Studies; D013313:Stress Disorders, Post-Traumatic / Q000097:blood* / Q000175:diagnosis*; D011795:Surveys and Questionnaires; D013739:Testosterone / Q000097:blood*; D055815:Young Adult
chemical_list: D013739:Testosterone
keywords: Deployment; Longitudinal analysis; Military personnel; Posttraumatic stress disorder; Testosterone