post-traumatic stress disorder
I was originally going to write this post for the 4th of July, given the subject matter. However, as regular readers know, I am not unlike Dug the Dog in the movie Up, with new topics that float past me in my social media and blog reading rounds serving as the squirrel. But never let it be said, though, that I don't circle back to topics that interest med. (Wait, strike that. Sometimes, that actually does happen. After all, I have been at this nearly 12 years now. It just didn't happen this time.) This time around, I will be using documents forwarded to me by a reader as a means of revisiting…
Never know what'll top the charts. Top post was a post I put up in January, "Pfizer takes $2.3 billion offl-label marketing fine." That post reported the news (via FiercePharma) that Pfizer had tucked away in its financial disclosure forms a $2.3 billion charge to end the federal investigation into allegations of off-label promotions of its Cox-2 painkillers, including Bextra. (Lot of money ... but it didn't quite wipe out the company's 2008 net income.) The company had set aside the money as part of a deal it was negotiating Justiice. Finalizing the deal, however, took until September. At…
After a rather intense two months of long-form work, I'm so far behind on blogging I don't know where to start. Forget the last two months and move on? Probably the best move. But beforehand, I want to note a few developments along major lines of interest. I'll start with PTSD.
Amid the stagnation on combat PTSD, the summer brought news of new programs from the UK and US militaries aimed to answer the call for more effective treatment for rising rates reported in vets of the wars in Iraq and Afghanistan. Mind Hacks was one of several blogs to report and comment on a new Royal Marine program…
As the comments and correspondence about my PTSD story and posts accrue, I've been pondering ways to pull out some of the most interesting, powerful, and affecting. I finally decided to just start posting some, sometimes with commentary, sometimes without. This is a story of many different colors and textures.
I'll start with this excerpt from a long, eloquent blog response to my story about PTSD at Scientific American by Kayla Williams, a vet of the Iraq War who blogs at VetVoice. Williams is accumulating quite a strong run of posts there, including posts on torture, being a woman veteran…
How accurately can medical professionals distinguish post-traumatic stress disorder from related conditions? Is it better to be safe than sorry, or is overdiagnosis hurting patients rather than helping them? These are some questions that ScienceBlogger and freelance journalist David Dobbs addressed in his article in the April edition of Scientific American, bringing light to data that suggests PTSD may be grossly overdiagnosed in soldiers returning from combat. The article's publication has prompted thoughtful discussion with counter examples that led Dobbs to the conclusion that PTSD is…
When you propose that we are overdiagnosing PTSD in vets, you run into not only a lot of flak but many offerings of evidence suggesting that we're missing a lot of cases. Since publishing my article on PTSD, I've received those arguments directly in comments, and on Wednesday, April 8, Salon published an article, "I am under a lot of pressure to not diagnose PTSD," by Michael de Yoanna and Mark Benjamin, that offers unsettling evidence that at least some doctors working for the VA are being pressed to not diagnose PTSD in combat vets.
So which is it? Are we under- or overdiagnosing PTSD in…
It didn't take long for my Scientific American story on PTSD to draw the sort of fire I expected. A doctor blogging as "egalwan" at Follow Me Here writes
[Dobbs] is critical of a culture which "seemed reflexively to view bad memories, nightmares and any other sign of distress as an indicator of PTSD." To critics like this, the overwhelming incidence of PTSD diagnoses in returning Iraqi veterans is not a reflection of the brutal meaningless horror to which many of the combatants were exposed but of a sissy culture that can no longer suck it up.
Doctor or not, he's seeing politics where my…
My story in the April 2009 Scientific American story, "The Post-Traumatic Stress Trap", just went online. Here's the opening:
In 2006, soon after returning from military service in Ramadi, Iraq, during the bloodiest
period of the war, Captain Matt Stevens of the Vermont National Guard began to have a problem with PTSD, or post-traumatic stress disorder. Stevens's problem was not that he had PTSD. It was that he began to have doubts about PTSD: the condition was real enough, but as a diagnosis he saw it being wildly, even dangerously, overextended.
[snip]
"Clinicians aren't separating the…