Chasiropoulou Ch, Siouti N, Mougiakos Th, Dimitrakopoulos S
414 Military Hospital of Athens, Psychiatric Clinic, P. Penteli, Greece.
Psychiatriki. 2019 Oct-Dec;30(4):291-298. doi: 10.22365/jpsych.2019.304.291.
Existing evidence and the diathesis-stress model hypothesis suggest that stress as an environmental factor may trigger the onset of psychiatric disorders, such as psychosis spectrum disorders, mood disorders, anxiety disorders, in people with an underlying vulnerability. The purpose of this study was to determine the period of time during military service at which symptomatology of clinical significance is more often developed, considering that stress of service and adaptation to its requirements is common to all army recruits. A retrospective file study for the years 2017-2018 was conducted in order to identify male soldiers who were hospitalized in the psychiatric clinic of 414 Athens Military hospital and diagnosed as F20-29, F30-39 and F40-48 according to ICD-10. The number of hospitalizations per clinical diagnosis and the time of onset relatively to the month of military service were examined. A total of 139 cases were screened, 119 of which had disorders falling into the diagnostic categories F20-29, F30-39 and F40-48. 53% of total hospitalizations took place within the first two months of a nine-month military service. It was found that the risk of disorder onset within the first two months of military service was statistically higher (OR=0.210, p=0.001) for a schizophrenic spectrum disorder (F20-29) compared to F30-39 and F40-48 disorders. After adjusting for potential confounders, such as heritability for psychiatric disorders, urbanicity, history of substance use or age, the risk for hospitalization within the first two months continued to be significantly predicted by F20-29 disorder (OR=0.255, p=0.022) compared to other diagnoses. Individuals vulnerable in developing a psychotic disorder appear to have lower stress tolerance and may manifest an earlier disease onset, when exposed to the stress of military service compared to subjects predisposed to develop mood or anxiety disorders. Stress during military service is of major importance for the emergence of the whole psychopathology spectrum, particularly in vulnerable individuals. The development of prevention and early intervention strategies is considered to be of particular importance to conscripts. The findings of the present study are in agreement with the diathesis-stress model and moreover suggest that people who subsequently develop a psychotic spectrum disorder have greater vulnerability to stress exposure.
现有证据和素质-应激模型假说表明，压力作为一种环境因素，可能会在具有潜在易感性的人群中引发精神障碍的发作，如精神病性谱系障碍、情绪障碍、焦虑障碍。本研究的目的是确定在兵役期间临床上具有显著意义的症状更常出现的时间段，因为服役压力和适应其要求对所有新兵来说都是常见的。为了确定在雅典414军事医院精神科住院、并根据ICD-10被诊断为F20 - 29、F30 - 39和F40 - 48的男性士兵，我们对2017 - 2018年的病历进行了回顾性研究。我们检查了每个临床诊断的住院次数以及相对于服役月份的发病时间。总共筛查了139例病例，其中119例患有属于F20 - 29、F30 - 39和F40 - 48诊断类别的疾病。在为期九个月的兵役的前两个月内，发生了53%的住院病例。研究发现，与F30 - 39和F40 - 48疾病相比，精神分裂症谱系障碍（F20 - 29）在兵役前两个月内发病的风险在统计学上更高（OR = 0.210，p = 0.001）。在对潜在混杂因素进行调整后，如精神障碍的遗传度、城市化程度、物质使用史或年龄，与其他诊断相比，F20 - 29疾病在头两个月内住院的风险仍然显著预测（OR = 0.255，p = 0.022）。与易患情绪或焦虑障碍的受试者相比，易患精神病性障碍的个体似乎具有较低的压力耐受性，并且在暴露于兵役压力时可能更早发病。兵役期间的压力对于整个精神病理学谱系的出现至关重要，尤其是在易受影响的个体中。预防和早期干预策略的制定被认为对新兵尤为重要。本研究的结果与素质-应激模型一致，并且还表明，随后发展为精神病性谱系障碍的人在暴露于压力时具有更大的易感性。
