Psychiatric causes of unfitness for military service

Abstract

Introduction

The national service is a duty for every Tunisian citizen. The knowledge of psychiatric causes of unfitness for military service would enable developing standardized procedures for selecting and psychiatric assessment of young candidates.

Objectives

Determination of the diagnostic categories, frequency and factors associated with psychiatric causes of unfitness for military service.

Method

This was a retrospective, descriptive study, performed on medical files of candidates examined between the 1^st of January and the 31^st of December 2015 at the military hospital of Tunis.

Results

Eight hundred and seventy-two subjects were examined as a part of an assessment for mental fitness for military service. They were male, single, with an average age of 23.73 ± 3.5 years. Alcohol was consumed by 17.9% of subjects, cannabis by 12.8% and psychotropic by 4.7%. Fourteen percent had self-mutilation, 8.5% had criminal record and 5.3% had tattoos. Military unfitness was found in 80.8% of cases. The main causes of unfitness were anti-social personality disorder (40.6%), hysterical neurosis (14.9%), adjustment disorders (14.5%) and limited intellectual level (7.5%). The average length of service before found unfit was 9.14 months for anti-social personality, 5.94 months for adjustment disorders and 1.78 months for psychotic disorders. This period was significantly longer for the personality disorders (8.62 months) compared to psychotic disorders (P = 0.013) or to non-psychotic disorders (5.05 months, P < 0.001).

Conclusion

The evaluation on the mental ability of military personnel must be performed at an early date, given the financial, material and human consequences that would result from a delayed diagnosis.

Disclosure of interest

The authors have not supplied their declaration of competing interest.