Nils Hüttermann, Francesco Pahnke, Karl-Heinz Renner, Jan Philipp Krüger, Ulrich Wesemann
{"title":"20年阿富汗战争和10年马里战争后军人精神障碍的累积发病率比较。","authors":"Nils Hüttermann, Francesco Pahnke, Karl-Heinz Renner, Jan Philipp Krüger, Ulrich Wesemann","doi":"10.1080/20008066.2025.2477422","DOIUrl":null,"url":null,"abstract":"<p><p><b>Background:</b> This study compares the mental health effects of deployment on soldiers that have been deployed to Afghanistan and Mali. The psychiatric disorders among Mali veterans represent a previously unstudied area, particularly when compared to the larger and more thoroughly researched group of Afghanistan veterans. This comparison will help shed light on the unique challenges faced by soldiers deployed in Mali.<b>Aims:</b> To gain better insight, all German armed forces personnel who were deployed to Mali before 2023 are compared with the total sample that was deployed to Afghanistan. Because there were more critical incidents per deployed soldier, the cumulative incidence rates of all mental disorders are expected to be higher among Afghanistan veterans.<b>Methods:</b> All <i>N </i>= 111,157 German soldiers who were deployed to Afghanistan (<i>n </i>= 93,000; 2001-2021) or Mali (<i>n </i>= 18,157; 2013-2022) were included. According to the Central Registry, which records all soldiers with documented deployment-related mental disorders, the number for these two missions was <i>n </i>= 2,652 (Afghanistan: <i>n </i>= 2,458; Mali: <i>n </i>= 194; female: <i>n </i>= 183; 6.9%). The cumulative incidence between the two deployments was compared using χ² tests. In addition, the frequency of diagnosis among affected soldiers was compared.<b>Results:</b> The cumulative incidence of all deployment-related mental disorders was higher among Afghanistan veterans (2.6% to 1.1%; OR = 2.51, 95% CI: [2.17, 2.91]). Afghanistan veterans had a higher cumulative incidence of PTSD, anxiety disorders, affective disorders and substance abuse, with ORs ranging from 1.6 to 4.1. PTSD was more common among Afghanistan veterans, while anxiety disorders were most common among Mali veterans.<b>Conclusion:</b> Mali veterans had significantly lower cumulative incidence rates for all mental disorders, but showed a shift in frequency towards more anxiety disorders. These findings have implications for optimising mental health training before and after deployments in Mali and similar areas.</p>","PeriodicalId":12055,"journal":{"name":"European Journal of Psychotraumatology","volume":"16 1","pages":"2477422"},"PeriodicalIF":4.2000,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11915723/pdf/","citationCount":"0","resultStr":"{\"title\":\"Cumulative incidence of mental disorders in military personnel after 20 years of war in Afghanistan and 10 years in Mali - a comparison.\",\"authors\":\"Nils Hüttermann, Francesco Pahnke, Karl-Heinz Renner, Jan Philipp Krüger, Ulrich Wesemann\",\"doi\":\"10.1080/20008066.2025.2477422\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><p><b>Background:</b> This study compares the mental health effects of deployment on soldiers that have been deployed to Afghanistan and Mali. The psychiatric disorders among Mali veterans represent a previously unstudied area, particularly when compared to the larger and more thoroughly researched group of Afghanistan veterans. This comparison will help shed light on the unique challenges faced by soldiers deployed in Mali.<b>Aims:</b> To gain better insight, all German armed forces personnel who were deployed to Mali before 2023 are compared with the total sample that was deployed to Afghanistan. Because there were more critical incidents per deployed soldier, the cumulative incidence rates of all mental disorders are expected to be higher among Afghanistan veterans.<b>Methods:</b> All <i>N </i>= 111,157 German soldiers who were deployed to Afghanistan (<i>n </i>= 93,000; 2001-2021) or Mali (<i>n </i>= 18,157; 2013-2022) were included. According to the Central Registry, which records all soldiers with documented deployment-related mental disorders, the number for these two missions was <i>n </i>= 2,652 (Afghanistan: <i>n </i>= 2,458; Mali: <i>n </i>= 194; female: <i>n </i>= 183; 6.9%). The cumulative incidence between the two deployments was compared using χ² tests. In addition, the frequency of diagnosis among affected soldiers was compared.<b>Results:</b> The cumulative incidence of all deployment-related mental disorders was higher among Afghanistan veterans (2.6% to 1.1%; OR = 2.51, 95% CI: [2.17, 2.91]). Afghanistan veterans had a higher cumulative incidence of PTSD, anxiety disorders, affective disorders and substance abuse, with ORs ranging from 1.6 to 4.1. PTSD was more common among Afghanistan veterans, while anxiety disorders were most common among Mali veterans.<b>Conclusion:</b> Mali veterans had significantly lower cumulative incidence rates for all mental disorders, but showed a shift in frequency towards more anxiety disorders. These findings have implications for optimising mental health training before and after deployments in Mali and similar areas.</p>\",\"PeriodicalId\":12055,\"journal\":{\"name\":\"European Journal of Psychotraumatology\",\"volume\":\"16 1\",\"pages\":\"2477422\"},\"PeriodicalIF\":4.2000,\"publicationDate\":\"2025-12-01\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11915723/pdf/\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"European Journal of Psychotraumatology\",\"FirstCategoryId\":\"3\",\"ListUrlMain\":\"https://doi.org/10.1080/20008066.2025.2477422\",\"RegionNum\":2,\"RegionCategory\":\"医学\",\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"2025/3/17 0:00:00\",\"PubModel\":\"Epub\",\"JCR\":\"Q1\",\"JCRName\":\"PSYCHIATRY\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"European Journal of Psychotraumatology","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.1080/20008066.2025.2477422","RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"2025/3/17 0:00:00","PubModel":"Epub","JCR":"Q1","JCRName":"PSYCHIATRY","Score":null,"Total":0}
Cumulative incidence of mental disorders in military personnel after 20 years of war in Afghanistan and 10 years in Mali - a comparison.
Background: This study compares the mental health effects of deployment on soldiers that have been deployed to Afghanistan and Mali. The psychiatric disorders among Mali veterans represent a previously unstudied area, particularly when compared to the larger and more thoroughly researched group of Afghanistan veterans. This comparison will help shed light on the unique challenges faced by soldiers deployed in Mali.Aims: To gain better insight, all German armed forces personnel who were deployed to Mali before 2023 are compared with the total sample that was deployed to Afghanistan. Because there were more critical incidents per deployed soldier, the cumulative incidence rates of all mental disorders are expected to be higher among Afghanistan veterans.Methods: All N = 111,157 German soldiers who were deployed to Afghanistan (n = 93,000; 2001-2021) or Mali (n = 18,157; 2013-2022) were included. According to the Central Registry, which records all soldiers with documented deployment-related mental disorders, the number for these two missions was n = 2,652 (Afghanistan: n = 2,458; Mali: n = 194; female: n = 183; 6.9%). The cumulative incidence between the two deployments was compared using χ² tests. In addition, the frequency of diagnosis among affected soldiers was compared.Results: The cumulative incidence of all deployment-related mental disorders was higher among Afghanistan veterans (2.6% to 1.1%; OR = 2.51, 95% CI: [2.17, 2.91]). Afghanistan veterans had a higher cumulative incidence of PTSD, anxiety disorders, affective disorders and substance abuse, with ORs ranging from 1.6 to 4.1. PTSD was more common among Afghanistan veterans, while anxiety disorders were most common among Mali veterans.Conclusion: Mali veterans had significantly lower cumulative incidence rates for all mental disorders, but showed a shift in frequency towards more anxiety disorders. These findings have implications for optimising mental health training before and after deployments in Mali and similar areas.
期刊介绍：
The European Journal of Psychotraumatology (EJPT) is a peer-reviewed open access interdisciplinary journal owned by the European Society of Traumatic Stress Studies (ESTSS). The European Journal of Psychotraumatology (EJPT) aims to engage scholars, clinicians and researchers in the vital issues of how to understand, prevent and treat the consequences of stress and trauma, including but not limited to, posttraumatic stress disorder (PTSD), depressive disorders, substance abuse, burnout, and neurobiological or physical consequences, using the latest research or clinical experience in these areas. The journal shares ESTSS’ mission to advance and disseminate scientific knowledge about traumatic stress. Papers may address individual events, repeated or chronic (complex) trauma, large scale disasters, or violence. Being open access, the European Journal of Psychotraumatology is also evidence of ESTSS’ stand on free accessibility of research publications to a wider community via the web. The European Journal of Psychotraumatology seeks to attract contributions from academics and practitioners from diverse professional backgrounds, including, but not restricted to, those in mental health, social sciences, and health and welfare services. Contributions from outside Europe are welcome. The journal welcomes original basic and clinical research articles that consolidate and expand the theoretical and professional basis of the field of traumatic stress; Review articles including meta-analyses; short communications presenting new ideas or early-stage promising research; study protocols that describe proposed or ongoing research; case reports examining a single individual or event in a real‑life context; clinical practice papers sharing experience from the clinic; letters to the Editor debating articles already published in the Journal; inaugural Lectures; conference abstracts and book reviews. Both quantitative and qualitative research is welcome.
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