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Mental health of Special Forces personnel deployed in battle

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To compare the mental health problems of Special Forces with regular forces engaged in combat in the Sri Lanka Navy (SLN).


A population-based descriptive study was carried out to compare the mental health problems of Special Forces with regular forces in the Sri Lanka Navy (SLN) deployed in combat areas for at least 1 year. Participants were selected by simple random sampling. The outcome measures were common mental disorder measured using the General Health Questionnaire, PTSD, fatigue, multiple physical symptoms and hazardous alcohol use.


Overall exposure to potentially traumatic events was high in both groups, with Special Forces experiencing significantly more traumatic events. More than 80% of the Special Forces had experiences of discharging weapons in direct combat, engaging in combat with enemy vessels and seeing the dead or wounded. Special Forces had significantly less common mental disorders, fatigue and fair or poor general health than regular forces. Fair or poor general health (21.1%) and fatigue (18.4%) were the commonest problems in the regular forces. Hazardous drinking was the commonest mental health problem among the Special Forces (17%). Prevalence of PTSD was 1.9% in the Special Forces and 2.9% among the regular forces. Exposure to traumatic events and problems with family life were identified as risk factors.


Elite troops suffered less negative mental health consequences than regular forces despite higher combat exposure. Comradeship and unit cohesion protected Special Forces from negative mental health outcome of combat.

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We thank Nico Jayasekera, Director, SLN Health Services for facilitating the study. We also thank Matthew Hotopf for granting permission to use the questionnaire and providing valuable feedback on the draft of the article and the Institute of Research and Development, Colombo for providing Sinhala translations of the scales.

Conflict of interest

The study was funded by the Department of Psychological Medicine, Faculty of Medicine, University of Colombo. The authors are civilians who provide honorary clinical services to the Sri Lanka Navy. They do not receive any financial remuneration for their services. The Sri Lanka Navy did not have any role in the design, conduct of the study or preparation of manuscript.

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Correspondence to Varuni de Silva.

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Hanwella, R., de Silva, V. Mental health of Special Forces personnel deployed in battle. Soc Psychiatry Psychiatr Epidemiol 47, 1343–1351 (2012).

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