A JAMA THEME ISSUE
Edited by Annette Flanagin, RN, MA, and Thomas B. Cole, MD, MPH
The neuropsychological effects of war-zone military deployment are unclear. Vasterling and colleaguesArticle report results of a cohort study in which active-duty Army soldiers completed performance-based neuropsychological tasks prior to and shortly after deployment to Iraq and their test performance was compared with soldiers not deployed overseas. The authors found that after return from Iraq deployment, soldiers demonstrated neuropsychological compromise in several dimensions including sustained attention, memory, confusion, and tension but found improvements in reaction time. In an editorial, Hotopf and WesselyArticle discuss the clinical significance and possible causes of the neurocognitive changes identified.
The optimal method to screen for intimate partner violence is not known. MacMillan and colleagues evaluated 3 approaches to screening—face-to-face interview and written or computer-based self-completed questionnaires—in emergency departments, family practices, and women's health clinics. The authors found that the prevalence of intimate partner violence ranged from 4.1% to 17.7% depending on the screening method, instrument, and health care setting. Other findings included that women preferred self-completed questionnaires vs face-to-face interviews and that computer-based screening did not increase the prevalence of reported intimate partner violence.
The prevalence of symptoms of mental health disorders among residents of Thailand affected by the December 2004 tsunami was assessed in population-based surveys and are reported by the Thailand Post-Tsunami Mental Health Study Group in 2 articles in this issue. In the first articleArticle, the investigators report that elevated rates of posttraumatic stress disorder (PTSD), anxiety, and depression were found among adults 8 weeks after the tsunami, and although declining, remained increased 9 months later. In the second articleArticle, high rates of PTSD and depression were documented at 8 weeks and 9 months after the tsunami among children aged 7 to 14 years. In an editorial, Silove and BryantArticle discuss cross-cultural assessment of trauma-related mental health symptoms and appropriate interventions, particularly in developing nations.
To assess the long-term effects of chemical warfare on mental health, Hashemian and colleagues surveyed civilian survivors of the 1980-1988 Iran-Iraq war who were exposed to conventional warfare, alone or combined with chemical weapon attacks. The authors found that individuals exposed to both high-intensity conventional warfare and chemical weapons attack had substantially higher risks of lifetime posttraumatic stress disorder (PTSD), current PTSD, and increased anxiety and depressive symptoms compared with persons exposed to high-intensity or low-intensity conventional warfare alone.
Alam and colleagues assessed the annual rate of symptomatic hyponatremia among patients treated for dehydrating diarrheal disease with a reduced osmolarity oral rehydration solution at 2 hospitals in Bangladesh. The authors found a lower incidence of symptomatic hyponatremia in patients treated with the reduced osmolarity rehydration solution compared with the previous year when a formulation with higher osmolarity was used.
“My uncle was a vibrant and tender man. He was a very necessary part of our lives. We grieved his sudden death; that it came by suicide laced that grief with guilt.” From “Heart Opening.”
Researchers are studying the long-term mental health impact of Hurricane Katrina on those who survived the disaster.
Effects of war on children's mental and physical health and physicians' role in mitigating the consequences.
An increased risk for schizophrenia associated with maternal starvation may be mediated by an increased rate of gene mutations.
Mental health in the aftermath of hurricanes Katrina and Rita.
Dr DeAngelis summarizes and comments on this week's issue. Go to http://jama.ama-assn.org/misc/audiocommentary.dtl.
For your patients: Information about posttraumatic stress disorder.
This Week in JAMA . JAMA. 2006;296(5):477. doi:10.1001/jama.296.5.477