Psychotic Disorders in the Veterans of Local Wars

Abstract

Objectives. To determine the frequency of leading psychopathological syndromes, dynamics, and comorbidities of schizophrenia and other endogenous psychoses in Russian veterans of local wars receiving hospital treatment. Materials and methods. A total of 685 patients receiving treatment in the psychiatric departments of a military hospital were studied: 264 veterans of local wars (the study group), 296 servicemen (personnel and reserves) who had not taken part in military engagements (reference group 1), whose mean age differed from that of the study group, and 125 servicemen (personnel and reserves) who had not taken part in military engagements and had the same mean age and age distribution as patients of the study group (reference group 2). Results and conclusions. Among veterans (patients of the study group), the frequency of delusional (schizotypic) psychoses was somewhat lower (7.2%) than among patients who had not taken part in military engagements (14.5% and 8.8%, respectively). Patients of all three groups were mainly diagnosed with schizophrenia (ICD-10 F20): 3.8% in the study group, 4.4% in reference group 1, and 4.0% in reference group 2. Other acute and chronic psychotic disorders (F22–F23) were rarer and were seen in 0.8%, 5.4%, and 3.2% of patients, respectively. Organic delusional disorders were diagnosed in 1.5% of veterans and 3.7% of patients in reference group 1 but were not seen in patients of reference group 2. Comorbidity with post-traumatic stress disorder (PTSD) and psychotic symptoms in veterans was less than 2% but was seen in 26.3% of patients with diagnoses of schizophrenia and other disorders. The incidence of PTSD symptoms in veterans with diagnosed schizophrenia and other delusional disorders was significantly lower than the incidence among all veterans (20% and 46.9%, respectively). No link was found between hallucinatory and delusional experiences and the actions of military stress factors in the study group. In most patients of the study group, psychotic symptomatology became manifest after combat stress ended, and the subsequent development and relapse of psychotic symptomatology occurred independently of the effects of wartime factors.