The Vietnam veteran ten years on.

A review of the literature has been made on the diagnostic, management and administrative procedures adopted by military psychiatrists during the Vietnam conflict. Initial reports of low rates of psychiatric attrition probably concealed much combat-related psychopathology by labelling these problems as administrative disciplinary infractions. In the later stages of the war, explosive outbreaks of substance, particularly heroin, abuse were noted as well as reports of serious violence directed towards superior officers and Vietnamese civilians. Successful coping styles adopted by the troops against combat stress, culture shock and anomie have also been described as have their stratagems for managing a return to a politically divided community. Studies on returned veterans point to ongoing psychopathology in the areas of post traumatic stress disorder and depression in proportion to the severity of the combat to which they were exposed. Increased rates of violence and alcoholism have yet to be demonstrated. The therapy of veterans with adjustment problems and post-combat psychiatric disorders has also been reviewed.