PTSD

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With understandable urgency, Secretary of Defense Leon Panetta has made suicide one of his top priorities, instructing commanders at all levels to feel acutely accountable for it. The numbers are startling. On average 1 active duty soldier is killing himself each day--twice the number of combat deaths and twice the civilian rate.

Apathy is our enemy. Pain, paradoxically, is our ally because it is one of the most powerful fuels we have to impel us to a different and better tomorrow.

The first half of the 20th century saw 2 world wars, indiscriminate aerial bombing of civilians, the dropping of the atomic bomb, and the Holocaust-all of which created intense trauma for soldiers and civilians.Yet it was not until the American intervention in a post-colonial civil war in Southeast Asia that the psychiatric community in the 1970s formally described what we now call PTSD.

In preparing DSM-IV, we worked hard to avoid causing confusion in forensic settings. Realizing that lawyers read documents in their own special way, we had a panel of forensic psychiatrists go over every word to reduce the risks that DSM IV could be misused in the courts.

When counseling trauma victims and patients with PTSD, do you ask them to retell the trauma or do you think this prolongs it?

Exposure-based therapies are highly effective for patients with anxiety disorders, to the extent that exposure should be considered a first-line, evidence-based treatment for such patients. In clinical practice, however, these treatments are underutilized, which highlights the need for additional dissemination and training.

Colonel David M. Benedek, MD-a psychiatrist-takes a brief look at the emotional fallout of war in veterans returning from Iraq and Afghanistan and points you to the "The Clinical Manual for Management of PTSD."

Members of the military returning from combat operations have high rates of substance abuse. They also often exhibit a co-occurring triad of posttraumatic stress disorder (PTSD), traumatic brain injury (TBI), and pain, which complicates the problems with substance abuse.

David Osser, MD, and his colleagues from Harvard Medical School summarize key aspects of the Psychopharmacology Algorithm for PTSD.

In this blog, Dr Pols reviews The Politics of War Trauma: The Aftermath of World War II in Eleven European Countries, by Jolande Withuis and Annet Mooij (eds).

The Arizona Psychiatric Society and the American Psychiatric Association joined together to remember the victims of the Tuscon tragedy. The shooting left 6 dead and 14 others wounded, including US Rep Gabrielle Giffords, who lies in a medically induced coma recovering from a gunshot wound to the head.

Which treatment was found to be detrimental to patients with PTSD? What is the Brøset Violence Checklist used for? These questions and more in this week's quiz.

There are feasible and replicable ways for caring adults to help heal themselves as well as the next generation through mass application of reflection and altruistic caring for the remaining offspring, whether in Sichuan, Gaza, New Orleans, or Haiti.

Results from a study published in the Journal of Psychopharmacology suggest that MDMA combined with psychotherapy may be a safe and effective treatment for symptoms of post-traumatic stress disorder.

Any effort to develop a diagnostic manual for world-wide use must grapple with the question of cross-cultural applicability. The description and diagnostic criteria for schizophrenia must work as well in East Timor as in the US or France. In this piece I choose PTSD to show the complexity of the cultural issue for DSM-5.