What is Post Traumatic Stress Disorder (PTSD)?
PTSD is a stress disorder caused by exposure to psychological trauma,
such as combat, sexual assault, or other life-threatening events. Veterans
with PTSD experience symptoms such as:
painful dreams and memories intense anxiety and depression disturbed
sleep suicidal and hostile impulses difficulty getting close to others
numbing of emotions social isolation trouble working or finding meaningful
activities The passage of time alone usually does not heal the wounds of
trauma. The natural desire to withdraw from others and not talk about
problems related to traumatic experiences may actually make matters worse
for veterans suffering from PTSD. Symptoms of PTSD improve with treatment
that usually includes counseling, medications, and assistance with finances,
housing, and employment.
Combat Duty in
Iraq and Afghanistan, Mental Health Problems, and Barriers to Care
Charles W. Hoge, M.D., Carl A. Castro,
Ph.D., Stephen C. Messer, Ph.D., Dennis McGurk, Ph.D., Dave I. Cotting,
Ph.D., and Robert L. Koffman, M.D., M.P.H.
Abstract: Background
The current combat operations in Iraq and Afghanistan have
involved U.S. military personnel in major ground combat and
hazardous security duty. Studies are needed to systematically
assess the mental health of members of the armed services who
have participated in these operations and to inform policy with
regard to the optimal delivery of mental health care to returning
veterans.
Methods We studied members of four U.S. combat infantry units
(three Army units and one Marine Corps unit) using an anonymous
survey that was administered to the subjects either before their
deployment to Iraq (n=2530) or three to four months after their
return from combat duty in Iraq or Afghanistan (n=3671). The
outcomes included major depression, generalized anxiety, and
post-traumatic stress disorder (PTSD),
which were evaluated on the basis of standardized,
self-administered screening instruments.
Results Exposure to combat was significantly greater among those
who were deployed to Iraq than among those deployed to Afghanistan.
The percentage of study subjects whose responses met the screening
criteria for major depression, generalized anxiety, or
PTSD was
significantly higher after duty in Iraq (15.6 to 17.1 percent)
than after duty in Afghanistan (11.2 percent) or before deployment
to Iraq (9.3 percent); the largest difference was in the rate
of PTSD. Of those whose
responses were positive for a mental disorder, only 23 to 40
percent sought mental health care. Those whose responses were
positive for a mental disorder were twice as likely as those
whose responses were negative to report concern about possible
stigmatization and other barriers to seeking mental health care.
Conclusions This study provides an initial look at the mental
health of members of the Army and the Marine Corps who were
involved in combat operations in Iraq and Afghanistan. Our findings
indicate that among the study groups there was a significant
risk of mental health problems and that the subjects reported
important barriers to receiving mental health services, particularly
the perception of stigma among those most in need of such care.
Source:
New England Journal of Medicine Volume 351:13-22 July 1, 2004 Number 1
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