This book takes a case-based approach to addressing the challenges psychiatrists and other clinicians face when working with American combat veterans after their return from a war zone. Written by experts, the book concentrates on a wide variety of concerns associated with posttraumatic stress disorder (PTSD), including different treatments of PTSD. The text also looks at PTSD comorbidities, such as depression and traumatic brain injury (TBI) and other conditions masquerading as PTSD. Finally, the authors touch on other subjects concerning returning veterans, including pain, disability, facing the end of a career, sleep problems , suicidal thoughts, violence, , and mefloquine “toxidrome”. Each case study includes a case presentation, diagnosis and assessment, treatment and management, outcome and case resolution, and clinical pearls and pitfalls. Post-Traumatic Stress Disorder and Related Diseases in Combat Veterans is a valuable resource for civilian and military mental health practitioners, and primary care physicians on how to treat patients returning from active war zones.
This document provides information on post-traumatic stress disorder (PTSD) and war-related stress for veterans & their families. It begins with background on PTSD and traumatic events, then describes common symptoms of PTSD and why they develop. The next section reviews problems associated with PTSD, such as depression, anxiety, and impacts on work & family. The final sections provide suggestions on coping with the disorder and describe treatment methods.
Vietnam still haunts the American conscience. Not only did nearly 58,000 Americans die there, but--by some estimates--1.5 million veterans returned with war-induced Post-Traumatic Stress Disorder (PTSD). This psychological syndrome, responsible for anxiety, depression, and a wide array of social pathologies, has never before been placed in historical context. Eric Dean does just that as he relates the psychological problems of veterans of the Vietnam War to the mental and readjustment problems experienced by veterans of the Civil War. Employing a multidisciplinary approach that merges military, medical, and social history, Dean draws on individual case analyses and quantitative methods to trace the reactions of Civil War veterans to combat and death. He seeks to determine whether exuberant parades in the North and sectional adulation in the South helped to wash away memories of violence for the Civil War veteran. His extensive study reveals that Civil War veterans experienced severe persistent psychological problems such as depression, anxiety, and flashbacks with resulting behaviors such as suicide, alcoholism, and domestic violence. By comparing Civil War and Vietnam veterans, Dean demonstrates that Vietnam vets did not suffer exceptionally in the number and degree of their psychiatric illnesses. The politics and culture of the times, Dean argues, were responsible for the claims of singularity for the suffering Vietnam veterans as well as for the development of the modern concept of PTSD. This remarkable and moving book uncovers a hidden chapter of Civil War history and gives new meaning to the Vietnam War.
Over 100 researchers from 16 countries contribute to the first comprehensive handbook on post-traumatic stress disorder. Eight major sections present information on assessment, measurement, and research protocols for trauma related to war veterans, victims of torture, children, and the aged. Clinicians and researchers will find it an indispensible reference, touching on such disciplines and psychiatry, psychology, social work, counseling, sociology, neurophysiology, and political science.
Since October 2001, approximately 1.64 million U.S. troops have been deployed for Operations Enduring Freedom and Iraqi Freedom (OEF/OIF) in Afghanistan and Iraq. Early evidence suggests that the psychological toll of these deployments -- many involving prolonged exposure to combat-related stress over multiple rotations -- may be disproportionately high compared with the physical injuries of combat. In the face of mounting public concern over post-deployment health care issues confronting OEF/OIF veterans, several task forces, independent review groups, and a Presidential Commission have been convened to examine the care of the war wounded and make recommendations. Concerns have been most recently centered on two combat-related injuries in particular: post-traumatic stress disorder and traumatic brain injury. With the increasing incidence of suicide and suicide attempts among returning veterans, concern about depression is also on the rise. The study discussed in this monograph focuses on post-traumatic stress disorder, major depression, and traumatic brain injury, not only because of current high-level policy interest but also because, unlike the physical wounds of war, these conditions are often invisible to the eye, remaining invisible to other servicemembers, family members, and society in general. All three conditions affect mood, thoughts, and behavior; yet these wounds often go unrecognized and unacknowledged. The effect of traumatic brain injury is still poorly understood, leaving a large gap in knowledge related to how extensive the problem is or how to address it. RAND conducted a comprehensive study of the post-deployment health-related needs associated with these three conditions among OEF/OIF veterans, the health care system in place to meet those needs, gaps in the care system, and the costs associated with these conditions and with providing quality health care to all those in need. This monograph presents the results of our study, which should be of interest to mental health treatment providers; health policymakers, particularly those charged with caring for our nation's veterans; and U.S. service men and women, their families, and the concerned public. All the research products from this study are available at http://veterans.rand.org. Data collection for this study began in April 2007and concluded in January 2008. Specific activities included a critical reviewof the extant literature on the prevalence of post-traumatic stress disorder, major depression, and traumatic brain injury and their short- and long-term consequences; a population-based survey of service members and veterans who served in Afghanistan or Iraq to assess health status and symptoms, as well asutilization of and barriers to care; a review of existing programs to treat service members and veterans with the three conditions; focus groups withmilitary service members and their spouses; and the development of a microsimulation model to forecast the economic costs of these conditions overtime. Among our recommendations is that effective treatments documented in the scientific literature -- evidence-based care -- are available for PTSD and major depression. Delivery of such care to all veterans with PTSD or majordepression would pay for itself within two years, or even save money, by improving productivity and reducing medical and mortality costs. Such care may also be a cost-effective way to retain a ready and healthy military force for the future. However, to ensure that this care is delivered requires system-level changes across the Department of Defense, the Department of Veterans Affairs, and the U.S. health care system.
Approximately 4 million U.S. service members took part in the wars in Afghanistan and Iraq. Shortly after troops started returning from their deployments, some active-duty service members and veterans began experiencing mental health problems. Given the stressors associated with war, it is not surprising that some service members developed such mental health conditions as posttraumatic stress disorder, depression, and substance use disorder. Subsequent epidemiologic studies conducted on military and veteran populations that served in the operations in Afghanistan and Iraq provided scientific evidence that those who fought were in fact being diagnosed with mental illnesses and experiencing mental healthâ€"related outcomesâ€"in particular, suicideâ€"at a higher rate than the general population. This report provides a comprehensive assessment of the quality, capacity, and access to mental health care services for veterans who served in the Armed Forces in Operation Enduring Freedom/Operation Iraqi Freedom/Operation New Dawn. It includes an analysis of not only the quality and capacity of mental health care services within the Department of Veterans Affairs, but also barriers faced by patients in utilizing those services.
The guideline offers clear, concise, and actionable recommendation statements to help clinicians to incorporate recommendations into clinical practice, with the goal of improving quality of care. Each recommendation is given a rating that reflects the level of confidence that potential benefits of an intervention outweigh potential harms.
