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Steinberg and Durell (1968) revisited: increased rates of First Episode Psychosis following military induction in Greek Army Recruits

Published online by Cambridge University Press:  22 August 2017

S. Dimitrakopoulos*
Psychiatric Clinic, 414 Military Hospital of Athens, P. Penteli, Greece 1st Department of Psychiatry, National and Kapodistrian University of Athens Medical School, Eginition Hospital, Athens, Greece
S. Vitoratou
Department of Biostatistics, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK
T. Mougiakos
Psychiatric Clinic, 414 Military Hospital of Athens, P. Penteli, Greece
N. Bogeas
Psychiatric Clinic, 414 Military Hospital of Athens, P. Penteli, Greece
O. Giotakos
Psychiatric Clinic, 414 Military Hospital of Athens, P. Penteli, Greece
J. van Os
Department Psychiatry and Psychology, Maastricht University Medical Centre, Maastricht, The Netherlands Department of Psychosis Studies, King's College London, King's Health Partners, Institute of Psychiatry, London, UK
N. C. Stefanis
1st Department of Psychiatry, National and Kapodistrian University of Athens Medical School, Eginition Hospital, Athens, Greece
*Address for correspondence: S. Dimitrakopoulos, M.D., 414 Military Hospital of Athens, Tax. Velliou 6, P. Penteli, 15236, Attiki, Greece. (Email:


Since the seminal study of Steinbeck and Durell (1968), few epidemiological studies have attempted to replicate whether psychosocial stress precipitates the onset of a first psychotic episode. Our aim was to support or refute the finding of elevated psychosis incidence in the first month of army induction and to examine factors impacting the timing of onset. Data were collected from medical files of 186 army conscripts, hospitalized with a diagnosis of First Episode Psychosis (FEP) between 2005 and 2014 in the Psychiatric Military Hospital in Athens, Greece. FEP rates were at least 4.5 times higher in the first month of military service, compared with any other month. Earlier FEP onset was associated with rural environment at the time of birth, multiple drug use and service away from home. Psychosocial stress precipitates FEP, particularly in those exposed to other risk factors.

Review Article
Copyright © Cambridge University Press 2017 

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