Psychiatric exemptions at call-up and during military service: A comparative study

Background: Military conscription is a legal obligation in many countries. Different psychiatric disorders may result in exemptions from compulsory military service. The study aimed to compare psychiatric diagnoses, and demographic and clinical characteristics of individuals exempted from conscription between the call-up and military service groups. Methods: The study analyzed exemption reports based on psychiatric evaluations conducted between 2016 and 2020 at a regional military hospital in Türkiye. Exemptions from conscription at the call-up stage and during military service were compared regarding sociodemographic characteristics, clinical information, and psychiatric diagnoses. Results: The study included 1225 exemption reports. The most common psychiatric diagnoses were intellectual disability and adjustment disorder. The exemption at the call-up group showed higher rates of psychiatric disability reports, intellectual disability, antisocial personality disorder, and depressive disorders. In contrast, the exemption during military service group had a higher history of substance use and prevalence of adjustment disorder. At the call-up, intellectual disability, antisocial personality disorder, and psychiatric medication predicted exemption. Adjustment disorder was the predictive factor for exemption during military service Conclusion: The study delineated crucial clinical and psychiatric distinctions among those exempted from conscription during call-up versus military service. Awareness of exemptions during military service can significantly contribute to improving the roll call examination during the call-up. The findings emphasize the need for targeted assessments and strategies for managing psychiatric disorders in the military context.