Indicators of mental disorders in contract military personnel (privates, sergeants, sergeant majors) of the Armed Forces of the Republic of Belarus (2003–2020)

Relevance. Extreme conditions of military activities increase the likelihood of developing mental maladaptation and mental disorders.

Intention. To аnalyze medical statistical indicators and the dynamics of mental disorders in military personnel serving under contract, and compare the obtained indicators with data from officers of the Armed Forces (AF) of the Republic of Belarus for 18 years (2003–2020).

Methodology. We analyzed reports on the state of health of personnel and the activities of the medical service by Form 3 / MED of military units in which about 80 % of the total number of military personnel under contract of the Republic of Belarus AF served in 2003–2020. Mental morbidity was correlated with groups (blocks) of Chapter V of the International Classification of Diseases and Behavioral Disorders of the 10th revision (ICD-10). Medical and statistical indicators were calculated for 10 thousand military personnel. The results were checked for the normality of distribution. The article presents arithmetic means and errors of mean values (M ± m). Time series were analyzed and second-order polynomial trends were calculated.

Results and Discussion. Over 2003–2020, in contract military personnel with mental disorders (ICD-10 Chapter V) overall morbidity averaged (102.53 ± 15.88) per 10 thousand military personnel / year with 1.15 % share of mental disorders; primary morbidity averaged (51.58 ± 8.58) and 0.81 %, respectively; hospital admissions, (23.06 ± 4.14) and 1.76 %, respectively; work days lost, (426.0 ± 65.5) and 1.28 %, respectively; dismissals, (4.00 ± 0.69) and 22.51 %, respectively. Polynomial trends showed a decrease in morbidity indicators with high coefficients of determination. Shares of mental disorders also decreased in the structure of morbidity indicators among contract military personnel for all ICD-10 chapters. For all morbidity indicators (excluding work days lost), the levels of mental disorders in contract servicemen were statistically significantly higher than in officers of the Republic of Belarus AF. In the structure of the military epidemiological significance of diseases for contract military personnel, indicators of neurotic, stress-related and somatoform disorders (ICD-10 Block 5) ranked 1st; mood [affective] disorders (Block 4) ranked 2nd; schizophrenia, schizotypal and delusional disorders (Block 3) ranked 3rd; behavioral syndromes associated with physiological disturbances and physical factors (Block 6) ranked 4th; mental and behavioral disorders due to psychoactive substance use (Block 2) ranked 5th. In total, these blocks accounted for 91.5 % of the structure of military epidemiological significance.

Conclusion. When conscripting candidates who have expressed a desire to serve under contract, and at the initial stage of service, it is necessary to more actively identify persons with mental addictions. Indicators of mental disorders will help calculate forces and assets of the medical service, and their prevention, timely detection and treatment will improve the mental health of contract servicemen and the reliability of their professional activities.

1. Voennaya psikhiatriya [Military psychiatry]. Eds.: V.K. Shamrei, A.A. Marchenko. Sankt-Peterburg. 2015. 440 p. (In Russ.)

2. Goncharenko A.Yu. Sistema monitoringa psikhicheskogo zdorov’ya voennosluzhashchikh, prokhodyashchikh voennuyu sluzhbu po kontraktu [The mental health monitoring system for contract military personnel]: Abstract dissertation Dr. Med. Sci. Sankt-Peterburg. 2017. 46 p. (In Russ.)

3. Evdokimov V.I., Chernov D.A. Pokazateli psikhicheskikh rasstroistvo ofitserov Vooruzhennykh sil Respubliki Belarus’ (2003–2020 gg.) [Mental disorders in officers of the Armed Forces of the Republic of Belarus (2003–2020)]. Vestnik psikhoterapii [Bulletin of Psychotherapy]. 2021;( 80):7–24. (In Russ.)

4. Evdokimov V.I., Chernov D.A., Sivashchenko P.P., Shamrei V.K. Pokazateli psikhicheskoi zabolevaemosti voennosluzhashchikh po prizyvu Vooruzhennykh sil Rossiiskoi Federatsii i Respubliki Belarus’ (2003–2018 gg.) [Mental disorders in military conscripts of the Armed Forces of the Russian Federation and the Republic of Belarus (2003–2018)]. Sankt-Peterburg. 2020. 89 p. (Seriya «Zabolevaemost’ voennosluzhashchikh» [Morbidity in Military]. Iss. 13). (In Russ.)

5. Lobachev A.V. Rasstroistva adaptatsii u voennosluzhashchikh: kliniko-organizatsionnye problemy [Adjustment disorders in servicemen: clinical and organizational issues]: Abstract dissertation Dr. Med. Sci. Sankt-Peterburg. 2021. 45 p. (In Russ.)

6. Poplevkin N.P. Institutsional’noe upravlenie sotsializatsiei voennosluzhashchikh, prokhodyashchikh voennuyu sluzhbu po kontraktu v Vooruzhennykh silakh Rossiiskoi Federatsii [Institutional management of the socialization of military personnel undergoing contract service in the Armed Forces of the Russian Federation]: Abstract dissertation PhD in Sociology. Moskva. 2019. 25 p. (In Russ.)

7. Ukazaniya po vedeniyu meditsinskogo ucheta i otchetnosti v Vooruzhennykh silakh Rossiiskoi Federatsii na mirnoe vremya [Guidelines for medical record keeping and reporting in the Armed Forces of the Russian Federation during peacetime]. Moskva. 2001. 40 p. (In Russ.)

8. Chernov D.A. Integral’nyi pokazatel’ narusheniya sostoyaniya zdorov’ya voennosluzhashchikh [Integral index of health impairment of servicemen]. Voennaya meditsina [Military medicine]. 2021;( 2):14–24. DOI: 10.51922/2074–5044.2021.2.14. (In Russ.)

9. Shamrei V.K., Evdokimov V.I., Lobachev A.V. [et al.]. Mediko-statisticheskie pokazateli psikhicheskikh rasstroistv u voennosluzhashchikh po kontraktu (ryadovye, serzhanty, starshiny) v 2003–2016 gg. [Medical and statistical indicators of mental disorders for contract servicemen (privates, sergeants, petty officers) in 2003–2016]. Vestnik psikhoterapii [Bulletin of Psychotherapy]. 2017;(62):36–60. (In Russ.)

10. Shamrei V.K., Evdokimov V.I., Sivashchenko R.R., Lobachev A.V. Osnovnye pokazateli psikhicheskikh rasstroistv ofitserov Vooruzhennykh sil Rossiiskoi Federatsii (2003–2015 gg.) [Key indicators for mental disorders in officers of the armed forces of Russia (2003–2015)]. Mediko-biologicheskie i sotsial’no-psikhologicheskie problemy bezopasnosti v chrezvychaynykh situatsiyakh [Medico-Biological and Socio-Psychological Problems of Safety in Emergency Situations]. 2017;( 1):66–76. DOI: 10.25016/2541-7487-2017-0-66-76. (In Russ.)

11. Shcherbakov D.V. Skriningovaya otsenka psikhicheskogo zdorov’ya voennosluzhashchikh, prokhodyashchikh sluzhbu po kontraktu [Screening assessment of the mental health of military personnel serving under contract]: Abstract dissertation PhD Med. Sci. Sankt-Peterburg. 1997. 15 p. (In Russ.)

12. Ambulatory visits, active component, U.S. Armed Forces, 2018. Armed Forces Health Surveillance Center (AFHSC). Medical Surveillance Monthly Report. 2019;26(5):19–25.

13. Hospitalizations, active component, U.S. Armed Forces, 2018. Armed Forces Health Surveillance Center (AFHSC). Medical Surveillance Monthly Report. 2019;26(5):11–18.

14. Kieffer J.W., Stahlman S. Mental health disorders, behavioral health problems, fatigue and sleep outcomes in remotely piloted aircraft/manned aircraft pilots, and remotely piloted aircraft crew, U.S. Air Force, 1 October 2003– 30 June 2019. Medical Surveillance Monthly Report. 2021;28( 8):14–21.

15. MacDonell G.V., Bhullar N., Thorsteinsson E.B. Depression, anxiety, and stress in partners of Australian combat veterans and military personnel: a comparison with Australian population norms. PeerJ. 2016;(4):2373. DOI: 10.7717/peerj.2373.

16. Mental disorders and mental health problems, active component, U.S. Armed Forces, 2000–2011. Armed Forces Health Surveillance Center. Medical Surveillance Monthly Report. 2012;19(6):11–17.

17. Summary of mental disorder hospitalizations, active and reserve components, U.S. Armed Forces, 2000–2012. Armed Forces Health Surveillance Center. Medical Surveillance Monthly Report. 2013;20(7):4–11; discussion 10–11.

18. UK Armed Forces mental health: Annual Summary & Trends Over Time, 2007/08–2013/14. 2014. 58 p.

19. Zamorski M.A., Bennett R.E., Rusu C. [et al.]. Prevalence of Past-Year Mental Disorders in the Canadian Armed Forces, 2002–2013. Can. J. Psychiatry. 2016;61(Suppl):26S–35S. DOI: 10.1177/0706743716628854.