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标题：Do soldiers seek more mental health care after deployment? Analysis of mental health consultations in the Netherlands Armed Forces following deployment to Afghanistan
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作者：Elisabeth (Liesbeth) M. Taal ; Eric Vermetten ; Digna (Anneke) J.F. van Schaik 等
期刊名称：European Journal of Psychotraumatology
印刷版ISSN：2000-8198
电子版ISSN：2000-8066
出版年度：2014
卷号：5
DOI：10.3402/ejpt.v5.23667
语种：English
出版社：Taylor & Francis Group
摘要：Background: Military deployment to combat zones puts military personnel to a number of physical and mental challenges that may adversely affect mental health. Until now, few studies have been performed in Europe on mental health utilization after military deployment.Objective: We compared the incidence of mental health consultations with the Military Mental Health Service (MMHS) of military deployed to Afghanistan to that of non-deployed military personnel.Method: We assessed utilization of the MMHS by the full cohort of the Netherlands Armed Forces enlisted between 2008 and 2010 through linkage of mental health and human resource information systems.Results: The total population consisted of 50,508 military (18,233 deployed, 32,275 non-deployed), who accounted for 1,906 new consultations with the MMHS. The follow-up was limited to the first 2 years following deployment. We observed higher mental health care utilization in deployed vs. non-deployed military personnel; hazard ratio (HR), adjusted for sex, military branch and time in service, 1.84 [95% CI 1.61–2.11] in the first and 1.28 [1.09–1.49] in the second year after deployment. An increased risk of adjustment disorders (HR 2.59 [2.02–3.32] and 1.74 [1.30–2.32]) and of anxiety disorders (2.22 [1.52–3.25] and 2.28 [1.50–3.45]) including posttraumatic stress disorder (5.15 [2.55–10.40] and 5.28 [2.42–11.50]), but not of mood disorders (1.33 [0.90–1.97] and 1.11 [0.68–1.82]), was observed in deployed personnel in the first- and second-year post-deployment, respectively. Military personnel deployed in a unit with a higher risk of confrontation with potentially traumatic events had a higher HR (2.13 [1.84–2.47] and 1.40 [1.18–1.67]).Conclusions: Though absolute risk was low, in the first and second year following deployment to Afghanistan there was an 80 and 30% higher risk for mental health problems resulting in a consultation with the Dutch MMHS compared to military never deployed to Afghanistan. These observations underscore the need for an adequate mental health infrastructure for those returning from deployment.Keywords: Military personnel; deployment; mental disorders; mental health care; service utilization; combat related stress disorders; hazard ratiosResponsible Editor: Rachel Yehuda, Mount Sinai School of Medicine, United States; J.J. Peters, VAMC, United States.This paper is part of the Special Issue: PTSD in the military: prevalence, pathophysiology, treatment. More papers from this issue can be found at http://www.eurojnlofpsychotraumatol.net(Published: 14 August 2014)Citation: European Journal of Psychotraumatology 2014, 5: 23667 - http://dx.doi.org/10.3402/ejpt.v5.23667
关键词：military personnel; deployment; mental disorders; mental health care; service utilization; combat related stress disorders; hazard ratios