Only a few European population-based studies on the epidemiology of posttraumatic stress disorder (PTSD) are available to date. This study aims to broaden the epidemiological knowledge of traumatic experiences (TEs), PTSD, and comorbid mental conditions in a representative German sample (N = 2510). The Composite International Diagnostic Interview list of traumatic events, the Posttraumatic Diagnostic Scale, and Patient Health Questionnaire (PHQ)-9 as well as PHQ-15 were used in this survey. Main results were low frequencies of TEs (24%) and PTSD (2.9%). Older participants (>60 years) reported significantly more TEs and more posttraumatic symptoms, whereas there was no significant difference in PTSD prevalence. A third of the subjects diagnosed with PTSD were found positive for depressive syndromes, and 27% were found positive for somatization syndrome. The results show that TEs and posttraumatic symptoms are frequent in senior citizens and thus have to be considered when treating older patients with mental health conditions.

Deployment abroad is associated with a high frequency of traumatic experiences and a two- to fourfold elevation of the risk of PTSD. Each year, about 300 cases of PTSD develop for every 10 000 soldiers who return to Germany; thus, the cumulative number of returnees with PTSD from the beginning of German deployment abroad may currently run into the thousands. 45% of all PTSD cases, or about one in two, are neither diagnosed nor treated. Deployment abroad also substantially increases the risk of developing a number of other mental disorders.

Investigation of the prevalence, incidence, and determinants of post-traumatic stress disorders (PTSD) and other mental disorders associated with military deployment in international missions poses several methodological and procedural challenges. This paper describes the design and sampling strategies, instruments, and experimental procedures applied in a study programme aimed to examine military deployment-related mental health and disorders (prevalence and trajectories) and to identify vulnerability and risk factors (e.g. age, gender, type of mission, rank, and duration of deployment and a wide range of neurobiological, psychological, social, and behavioural factors). The study comprised two components. The first component, a cross-sectional study, included 1483 deployed and 889 non-deployed German soldiers (response rate, 93%) who served during the 2009 International Security Assistance Force (ISAF) mission. A standardized diagnostic instrument (Composite International Diagnostic Interview, CIDI) coupled with established questionnaires was administered to detect and diagnose PTSD and a broad spectrum of mental disorders and mental health problems. The second component, a prospective-longitudinal study, included 621 soldiers examined before (2011) and after return (2012) from the ISAF mission. In addition to the CIDI and questionnaires, several experimental behavioural tests and biological markers were implemented to probe for incident mental disorders, mental health problems and risk factors. Our methods are expected to provide greater precision than previous studies for estimating the risk for incident deployment-related and non-deployment-related disorders and their risk factors. We expect the findings to advance our understanding of a wide spectrum of adverse mental health outcomes beyond PTSD.

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Theoretischer Hintergrund: Noch immer ist wenig über die empirische Struktur von traumatischem Stress und die Assoziationen zwischen Stressoren und psychischen Erkrankungen bekannt, insbesondere nach militärischen Auslandseinsätzen. Methode: 1483 Bundeswehrsoldaten, die 2009/2010 in Afghanistan eingesetzt waren, wurden mittels der militärischen Version eines diagnostischen Interviews (MI-CIDI) untersucht. Zwei Klassifikationsmodelle wurden auf die Items der Liste einsatzbezogener Stressoren des US-MHAT-VI-Reports angewendet und konfirmatorische Faktorenanalysen durchgeführt. Ergebnisse: Aufgrund hoher polychorischer Korrelationen zwischen Items verschiedener Klassen und hoch negativer Korrelationen innerhalb derselben Klasse ergaben die Faktorenanalysen keine zufriedenstellende Modellpassung. Es wurden auch keine unterschiedlichen prädiktiven Wertigkeiten im Hinblick auf einsatzbedingte psychische Erkrankungen gefunden. Schlussfolgerungen: Die Ergebnisse stimmen nicht mit denen vergangener Studien überein und sprechen für den Einfluss von spezifischen Einsatzbedingungen auf die Struktur traumatischer Stressoren.