PTSD IN THE MILITARY: PREVALENCE, PATHOPHYSIOLOGY, TREATMENT Do soldiers seek more mental health care after deployment? Analysis of mental health consultations in the Netherlands Armed Forces following deployment to

Background: Military deployment to combat zones puts military personnel to a number of physical and mental challenges that may adversely affect mental health. Until now, few studies have been performed in Europe on mental health utilization after military deployment. Objective: We compared the incidence of mental health consultations with the Military Mental Health Service (MMHS) of military deployed to Afghanistan to that of non-deployed military personnel. Method: We assessed utilization of the MMHS by the full cohort of the Netherlands Armed Forces enlisted between 2008 and 2010 through linkage of mental health and human resource information systems. Results: The total population consisted of 50,508 military (18,233 deployed, 32,275 non-deployed), who accounted for 1,906 new consultations with the MMHS. The follow-up was limited to the first 2 years following deployment. We observed higher mental health care utilization in deployed vs. non-deployed military personnel; hazard ratio (HR), adjusted for sex, military branch and time in service, 1.84 [95 % CI 1.612.11] in the first and 1.28 [1.091.49] in the second year after deployment. An increased risk of adjustment disorders (HR 2.59 [2.023.32] and 1.74 [1.302.32]) and of anxiety disorders (2.22 [1.523.25] and 2.28 [1.503.45]) including posttraumatic stress disorder (5.15 [2.5510.40] and 5.28 [2.4211.50]), but not of mood disorders (1.33 [0.901.97] and 1.11 [0.681.82]), was observed in deployed personnel i