Pre-disease detection of stress-associated disorders in combatants depending on professional activity profile

Relevance. Combat stress and other forms of stress-associated mental disorders, as well as their consequences currently remain a most urgent issue in military personnel directly or indirectly involved in armed conflicts. Active deployment of weapons for remote destruction of manpower and infrastructure has caused qualitative transformations in the profile of medical casualties, thus becoming a powerful stress factor of intense psychological pressure on personnel. The fundamentally new nature of armed confrontations, which in many ways is incompatible with domestic experience acquired over the recent decades during local hostilities in the "hot zones", is gaining relevance, as well as effective prevention and treatment of health disorders associated with combat mental trauma in the personnel deployed in the special military operation. The objective is to identify pre-disease characteristics of stress-associated disorders in combatants, depending on their professional activity profile.Methods. We examined 209 males earlier deployed in combat zones. All the examined combatants were divided in three groups according to professional criteria: group 1 – employees of the Ministry of Internal Affairs of Russia (n = 71); group 2 – soldiers of the National Guard of Russia (the Rosgvardiya) (n = 70); group 3 – employees of the EMERCOM of Russia (n = 68). Clinical and psychopathological examination with prior blood chemistry and toxicological screening were conducted to identify metabolites of psychoactive substances.Results and discussion. Although the research showed an elevated risk of post-traumatic stress disorder in the combatants across all the three groups, employees of the EMERCOM of Russia and the Ministry of Internal Affairs of Russia demonstrated average stress coping ability, whereas soldiers of the National Guard of Russia showed higher levels of maladaptation and greater susceptibility to subclinical anxiety and depressive disorders. Combatants directly involved in combat operations often resort to alcohol or sedatives.Conclusion. Programs for medical and psychological rehabilitation implemented as part of psychological and psychiatric prevention efforts shall be adjusted to the combatants’ professional profile with a specific focus on the type of combat service duties.