{
  "abstract": "Introduction Military personnel face unique occupational stressors that increase the risk of post-traumatic stress disorder (PTSD) and other mental disorders, but population-based evidence from Asian military populations remains limited. We compared the risk of PTSD and other mental disorders between professional military personnel and reference populations in the Republic of Korea.Methods We conducted a retrospective cohort study using nationwide health insurance claims data from 2002 to 2021. We identified 544 709 professional military personnel, 4 054 102 individuals in the working population and 5 474 515 individuals in the general population. The primary outcome was incident PTSD; secondary outcomes included stress-related disorders, depressive episodes, recurrent depressive disorder, anxiety disorders and alcohol use disorders. HRs were estimated using Cox proportional hazards regression adjusted for age and sex.Results Among 544 709 professional military personnel followed up for 20 years, 579 PTSD cases were identified (crude incidence rate: 1.45 per 10 000 person-years). The HR for PTSD was 1.45 (95% CI 1.32 to 1.60) compared with the general population and 1.41 (95% CI 1.27 to 1.56) compared with the working population. Male military personnel had an HR of 1.23 (95% CI 1.10 to 1.38), while female military personnel had an HR of 3.85 (95% CI 3.07 to 4.81) compared with the general population. Stress-related disorders were also elevated (HR 1.36, 95% CI 1.32 to 1.40). In contrast, military personnel had lower risks of depressive episodes (HR 0.84), recurrent depressive disorder (HR 0.59), anxiety disorders (HR 0.83) and alcohol use disorders (HR 0.51) compared with the general population.Conclusions Professional military personnel in the Republic of Korea had elevated PTSD risk, with particularly high risk among female service members. The lower risks of other mental disorders were consistent with the healthy worker effect. These findings support enhanced mental health surveillance for military personnel.",
  "authors": [
    {
      "affiliations": [
        "Department of Social and Preventive Medicine, College of Medicine, Inha University, Michuhol-gu, Incheon, Republic of Korea",
        "Department of Occupational and Environmental Medicine, Inha University Hospital, Jung-gu, Incheon, Republic of Korea"
      ],
      "name": "Yangwoo Kim"
    },
    {
      "affiliations": [
        "Hanyang University Seoul Hospital, Seongdong-gu, Seoul, Republic of Korea"
      ],
      "name": "Kyungho Ju"
    },
    {
      "affiliations": [
        "Occupational and Environmental Medicine, Hanyang University College of Medicine, Seongdong-gu, Seoul, Republic of Korea",
        "Graduate School of Public Health, Hanyang University, Seongdong-gu, Seoul, Republic of Korea"
      ],
      "name": "Inah Kim"
    },
    {
      "affiliations": [
        "Hanyang University Seoul Hospital, Seongdong-gu, Seoul, Republic of Korea",
        "Occupational and Environmental Medicine, Hanyang University College of Medicine, Seongdong-gu, Seoul, Republic of Korea"
      ],
      "name": "Jeehee Min"
    },
    {
      "affiliations": [
        "Occupational and Environmental Medicine, Hanyang University College of Medicine, Seongdong-gu, Seoul, Republic of Korea",
        "Korean Industrial Health Association, Seocho-gu, Seoul, Republic of Korea"
      ],
      "name": "Jaechul Song"
    },
    {
      "affiliations": [
        "Occupational and Environmental Medicine, Hanyang University College of Medicine, Seongdong-gu, Seoul, Republic of Korea"
      ],
      "name": "Tae-Won Jang"
    }
  ],
  "title": "Risk of post-traumatic stress disorder and other mental disorders among professional military personnel in the Republic of Korea: a nationwide cohort study",
  "uid": "312a2b4a-1175-5b2e-95b5-1779930db8fa"
}