Post-traumatic stress disorder in combatants: prevalence, heterogeneity, and therapeutic approaches

Abstract

This scientific review analyzes and synthesizes findings from 70 contemporary scientific sources, published in Russian and English over the past 8 years, concerning post-traumatic stress disorder (PTSD) in military conflict participants. A significant disparity in the disorder's prevalence data was identified, which is attributed to variations in diagnostic methodologies. The etiology of PTSD is multifactorial, with key roles played not only by the intensity of combat experience but also by moral injury and guilt; the transition to civilian life frequently triggers the disorder's manifestation. The clinical presentation is complex, characterized by high comorbidity with depression and addiction, encompassing Complex PTSD (C-PTSD) and psychosomatic symptoms, thereby elevating the risk of somatic diseases and suicidal behavior. The review highlights modern approaches to multi-level prevention and comprehensive therapy. It is noted that standard psychotherapeutic methods require adaptation for the veteran population. Promising emerging directions include virtual reality (VR) therapy, physical activity, and digital technologies. Stigmatization and career concerns are identified as key barriers to seeking help, which underscores the critical role of social support in the rehabilitation process.