Friday, August 18, 2006

Was the Incidence of PTSD Overdiagnosed in Vietnam Veterans?

That's the obvious conclusion one would draw from an article by Benedict Carey in the New York Times, Less Post-Traumatic Stress Seen in Vietnam Vets.
Far fewer Vietnam veterans suffered from post-traumatic stress as a result of their wartime service than previously thought, researchers are reporting today, in a finding that could have lasting consequences for the understanding of combat stress, as well as for the estimates of the mental health fallout from the Iraq war.

The report, published in the journal Science and viewed by experts as authoritative, found that 18.7 percent of Vietnam veterans developed a diagnosable stress disorder that could be linked to a war event at some point in their lives, well under the previous benchmark number of 30.9 percent. And while the earlier analysis found that for 15.2 percent of the veterans the symptoms continued to be disabling at the time they were examined, the new study put that figure at 9.1 percent.
But before mentioning the Science article, I must point out two more gems in the current NYT:

(1) Is This What Happiness Looks Like? by Dan Shaw.

Gordon M. Grant for The New York Times

Um, no, this is what kitsch looks like!
And in the fall “The Architecture of Happiness,” by the philosopher Alain de Botton, who lives in England, will be published in the United States. In it he argues that physical environment is a crucial contributor to well-being. Like it or not, he suggests, the spaces we live in shape our sense of happiness and of self, so we had better choose them carefully.

Even before this vogue took hold in America, however, a number of influential East Coast decorators were exploring the same issues, and advancing a theory of their own: that a maximalist, color-saturated approach to interiors is a secret to happiness — maybe even the secret.

“Your home should be like a good dose of Zoloft,” Jonathan Adler, the ceramist and decorator, and one of the most prominent members of this group, wrote in his 2005 book, “My Prescription for Anti-Depressive Living.”

(2) And the most e-mailed article is a VERY IMPORTANT update on eyebrows, Throw Your Tweezers Away by Natasha Singer.

Ladies, lay down your tweezers. Facial hair hasn’t been this much in demand since the advent in 1978 of Brooke Shields.

Better watch out for the Skin Deep.

Now OF COURSE this is more important than war and PTSD...
Psychiatric Casualties of War
Richard J. McNally
Science 18 August 2006: Vol. 313. no. 5789, pp. 923 - 924.

The prevalence of posttraumatic stress disorder in Vietnam veterans has been a controversial medical and political issue. A new analysis provides better data and more robust conclusions.

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At August 23, 2006 7:22 PM, Blogger Dan Dright said...


crap! had all caps on. sorry.

I generally object to a couple of things on principle:

1. I hate it when people re-analyze data. Or do meta analyses. Statistics are very powerful in the hands of a skillful practitioner--but beware the dark side.

2. When you throw out a diagnosis out of the DSM, already you've taken the whole thing one step out of the realm of empiric biological science. Now you're interpreting observations according to something that is inherently vulnerable to inter-rater unreliability.

3.You've thrown a subjective category over a change in the brain. You're also dealing with crap data about how these people were before they went to war, and what is the control?

4. War sucks. Vets got treated like shit. I don't give a rat's ass if they all came back with double the IQ, a bigger penis, and a smile on their faces 24-7. But they didn't.and there's 51,195 who didn't come back at all. Look here:


At August 24, 2006 1:19 AM, Blogger The Neurocritic said...

Hi Dan, glad to see you.

I wanted to do another post on how this study will be used to justify budget cuts at VA mental health clinics, but it was just too depressing... so more about eyebrows first.


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