Ukrainian Military Hospital retrospective analysis during a decade of conflicts (3995 records) unveils specific mental health ICD-10-CM distribution per rank and the long-lasting impact of active conflict or trench warfare. Most hospitalizations in all years of observation were among soldiers. Anxiety-related disorders have been present since 'peacetime', mainly among professional soldiers and high ranks, pointing to the need for rank-tailored psychological training in skills to reduce the anxiety burden. High frequency of psychoactive substance use emerged with acute conflicts and in nonprofessional soldiers during wartime. This dictates the need to strengthen the selection of military personnel, considering the tendency to addiction. Military operations multiply the hospitalizations in psychiatric hospitals. The data warn about a 'need for free beds effect', which is worse for soldiers. This is relevant to estimating and planning the need for hospital resources for the current situation where the general population has been recruited for defense. In the current war, tightening the rules of sobriety in units and up to a ban on the sale of alcoholic beverages in areas where hostilities are taking place is recommended. The specific impact on nonprofessional soldiers is relevant to the current war, with the general population of Ukraine recruited for defense and combat.
Keywords: ICD-10; Ukraine; anxiety; mental health; military rank; psychoactive drug use; soldiers; stress; war.