One in every two cases of post-traumatic stress disorder (PTSD) in soldiers remains undiagnosed. This is the conclusion reached by a working group led by Hans-Ulrich Wittchen et al. They report their study in the current issue of Deutsches Ärzteblatt International (Dtsch Arztebl Int 2012; 109(35–36): 559–568), which is a special issue focusing on the prevalence of psychological stress in German army soldiers. In a second original article, results reported by Jens T Kowalski and colleagues show that more female soldiers contact the psychosocial support services provided by Germany’s armed forces than their male colleagues (Dtsch Arztbl Int 2012; 109 (35–36): 559–568).
Wittchen et al. draw attention to the fact that thus far no information has been available on how commonly soldiers have traumatic experiences during deployments to Afghanistan and develop PSTD. In their study, 85% of all soldiers deployed overseas reported at least one distressing event, but usually several such events. Overseas deployment is associated with twice or four times the risk of PTSD for soldiers. In international comparison, the prevalence of PTSD is notably lower in German soldiers, at 2.9%, than in soldiers from other countries who are deployed in the same regions. However, the estimated proportion of undiagnosed and untreated cases of PTSD is 45%.
Kowalski et al. explain that it is not only Afghanistan from where soldiers return in a traumatized state but also Kosovo. The number of Kosovo returnees with mental problems in their study increased significantly compared to the number of traumatized soldiers returning from Afghanistan. The study is based on hospital data of all German army psychiatric wards; these data evaluated the psychiatric morbidities between January 2010 through June 2011. The most common diagnoses were adjustment disorders, PSTD, and mild and moderate depressive episodes.