Psychiatric disorders following return from combat duty during the twenty-first century

Knowledge of the psychiatric consequences of combat deployment expanded rapidly during the late 20th century as large numbers of Vietnam veterans experienced substantial difficulties with readjustment upon return from deployment. Current warfare in Afghanistan and Iraq has resulted in the longest period of sustained combat exposure for United States forces since Vietnam. This article compares the nature of conflict, composition of deployed forces, combat exposures, and injuries in these deployment settings compared to late 20th century conflicts. It also reviews early findings on rates of psychiatric disorders among returning troops and compares these findings with those of studies of troops returning from prior conflicts. Evaluation and treatment approaches to posttraumatic stress disorder in combat veterans are then provided. Preliminary findings suggest that early assessment of veterans may not represent the long-term psychiatric needs of returning veterans and that ongoing surveillance and availability of psychiatric care will be needed for this population.