The changing patterns of psychiatric problems in Vietnam

I contend that military psychiatrists have been premature in suggesting that the Vietnam conflict has produced fewer psychiatric casualties than previous wars. While the number of men hospitalized and evacuated because of psychiatric problems has decreased, there has been a concurrent increase in disciplinary problems, drug abuse, and in the number of men diagnosed as character disorders. For some of our troops, duty in Vietnam has produced significant feelings of depression and guilt and has led to a rejection of any identification with the military. Other soldiers have turned to drug abuse as an escape from their distress. Men with character disorders sometimes act out their conflicts in antisocial behavior. The varying patterns of group formation in combat and support units determine whether this behavior will be directed towards Vietnamese or U.S. personnel. Antisocial behavior and drug abuse are symptomatic of emotional distress and have replaced combat fatigue as the predominant psychiatric syndromes among United States troops in Vietnam.