Biopsychosocial markers of post-traumatic stress disorder in combatants

Relevance. Military personnel combat stress disorders, including post-traumatic stress disorder (PTSD), arising from the impact of the stress combat situation factors on the psyche, lead to social maladaptation and decreased combat capacity. Timely diagnosis and further prevention of various stress-associated mental disorders helps to avoid progression into a chronic disease and concomitant psychosomatic pathologies.

The objective is to identify PTSD biopsychosocial markers in combatants.

Methods. Clinical psychopathological examination, biochemical and chemical toxicity studies (CTI) were conducted to identify metabolites of psychoactive substances. 85 male officers of the Russian Guard were examined following up to 90 day’s deployment in the combat zone in 2022–2023; those were split into Group I (38 individuals who underwent outpatient treatment for PTSD (F43.1), average age (28.4 ± 2.2) years and service experience (2.9 ± 1.4) years) and Group II (47 individuals with no diagnosed mental disorders, average age (29.2 ± 2.1) years and service experience (3.1 ± 1.2) years).

Results and discussion. The two groups revealed significant differences for all test parameters, i.e. PTSD risk, anxiety and depression levels. The group that included combatants seeking psychiatric aid demonstrated remarkably higher levels, revealing positive reliable correlations between PTSD and biochemical parameters, ethyl glucuronide, testosterone and midnight cortisol.

Conclusion. Taking into account specific social and political settings, as well as the scale and intensity of military action, further improvement is demanded in the examination of combatants using multiaxial biopsychosocial framework of markers, including both clinical and psychological screening, as well as chemical, toxicological and biochemical studies, as prescribed by the regulation of the Ministry of Health of Russia and the Ministry of Internal Affairs of Russia, is necessary to change. Considering the elevated values obtained by the TSQ and HADS questionnaires, the additional markers of PTSD development in combat officers may include elevated testosterone, midnight cortisol, carbohydrate-deficient transferrin, as well as the ethyl glucuronide and benzodiazepines in biological samples.

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