Madsen T, Sadowa Vedtofte M, Nordentoft M, Ravnborg Nissen L, Bo Andersen S
Psychiatric Center Copenhagen, Copenhagen University Hospital, Hellerup, Denmark.
The Danish Veteran Centre, Research and Knowledge Centre, Ringsted, Denmark.
Acta Psychiatr Scand. 2017 Jun;135(6):564-572. doi: 10.1111/acps.12736. Epub 2017 May 3.
Insight on how different missions have impacted rates of mental health service (MHS) utilization is unexplored. We compared postdeployment MHS utilization in a national cohort of first-time deployed to missions in Balkan, Iraq, and Afghanistan respectively.
A prospective national cohort study of 13 246 first-time deployed in the period 1996 through 2012 to missions in Balkan area, Iraq, or Afghanistan respectively. Soldiers 'MHS utilization was also compared with a 5:1 sex-, age-, and calendar year-matched never-deployed background population. Postdeployment utilization of MHS was retrieved from national coverage registers. Using Cox survival analyses, participants were followed and compared with regard to receiving three different types of psychiatric services: (i) admission to psychiatric hospital, (ii) psychiatric outpatient contact, and (iii) prescriptions of psychotropics.
Utilizing of psychiatric outpatient services and psychotropics was significantly higher in first-time deployed to Iraq and Afghanistan compared with deployed to Balkan. However, the rate of postdeployment admission to psychiatric hospital did not differ between missions. Postdeployment rates of psychiatric admission and psychiatric outpatient treatment were significantly higher in Afghanistan-deployed personnel compared with the background population.
Utilization of MHS differed significantly between mission areas and was highest after the latest mission to Afghanistan.
不同任务对心理健康服务（MHS）利用率的影响尚未得到探讨。我们比较了分别首次被部署到巴尔干、伊拉克和阿富汗执行任务的全国队列军人部署后MHS的利用率。
一项前瞻性全国队列研究，研究对象为1996年至2012年期间分别首次被部署到巴尔干地区、伊拉克或阿富汗执行任务的13246名军人。还将军人的MHS利用率与按性别、年龄和日历年以5:1比例匹配的从未部署过的背景人群进行了比较。MHS的部署后利用率从国家覆盖登记册中获取。使用Cox生存分析，对参与者进行随访，并就接受三种不同类型的精神科服务进行比较：（i）入住精神病医院，（ii）精神科门诊就诊，以及（iii）精神药物处方。
与被部署到巴尔干地区的军人相比，首次被部署到伊拉克和阿富汗的军人使用精神科门诊服务和精神药物的比例显著更高。然而，各任务之间部署后入住精神病医院的比例没有差异。与背景人群相比，部署到阿富汗的人员部署后精神科住院和精神科门诊治疗的比例显著更高。
MHS的利用率在不同任务地区之间存在显著差异，在最近一次部署到阿富汗的任务之后利用率最高。
