Rapid Responses to:
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Rapid Responses: Rapid Responses published:
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Amended version
- Michael E Reschen (5 November 2006)
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stigma attached to the diagnosis of PTSD
- sreedharan amarjothi nagendran (7 November 2006)
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Michael E Reschen, SHO General Medicine JR OX3 9DU
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Dear Editor, Unfortunately, as previously discussed, it was not logistically possible for you to amend the paper version of my letter (although the press release was amended) and i would therefore like to submit my corrected version as a 'rapid update'. The main alteration is that the reference has been corrected to a more up-to-date paper. Rather alarmingly the media has widely misreported the term SHO, and cited me as a 'leading doctor' - i am not a leading doctor or even a senior doctor and my comments are my own personal reflections and do not represent the opinion of the Oxford Radcliffe trust. "Dr Rana makes a very valid point regarding the psyhological effects on the Iraqi population stemming from their exposure to an apparent vast increase in violent death as reported in the Lancet. Previous studies have suggested that the risk of developing posttraumatic stress disorder following a traumatic event ranges from 7.5% to 72.%, with the risk being highest in those exposed to sustained combat trauma (1). With an excess of over 500,000 violent deaths there will no doubt have been many more people exposed to grave violence. It therefore seems likely that the nation of Iraq may suffer a double blow, firstly by losing a sizebable proportion of its working population and secondly by the significant consequences of people suffering post-traumatic stress disorder. This may also be compounded by cultural barriers which prevent people from seeking pyschological help. The mainstay of the coalition's medical effort has been understandably directed at assisting with basic medical help and treating injured civilians in Iraqi or coalition hospitals. The medical literature provides ample examples of rebuilding psychiatric facilities in a post-war era, most notably the experiences of doctors in Croatia following the invasion by coalition forces. We must learn the lessons of history and expedite the psychiatric help for Iraqi civilians. 1. J Clin Psychiatry 2000;61[suppl 5]:4-12 Posttraumatic Stress Disorder: The Burden to the Individual and to Society 2. Med Arh. 2001;55(1 Suppl 1):5-23 Reconstruction of mental health services in Bosnia and Herzegovina" Further to my letter i would add that although post-traumatic stress disorder remains a somewhat controversial diagnosis, especially outside the west, my letter was aimed at highlighting an aspect of the wellfare of Iraqi civillians which I feel has thus far been underreported. kind regards, Michael Reschen Competing interests: None declared |
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sreedharan amarjothi nagendran, psychiatrists brooker centre halton general hospital runcorn wa7 2da
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It was quite clear from Dr. Rana's article on the mental health consequences of the Iraq war that we also have to remember that people in developing countries like Iraq where any form of mental illness is considered as a stigma would face considerable difficulty in getting the appropriate help. Also the illness would be underreported due to the lack of resources to collect accurate data on people developing mental illness as a consequence of a war, as the main aim would be to be regenerate the economy of the country. Hence routine screening for mental illness should be performed at government hospitals, as it would be the only way to detect and offer the appropriate help. Public education, through the print and electronic media, open days, and support of mental hospitals all go to de-mystify mental in health, and go along way to reduce the prejudice against mentally ill people and mental illness. Competing interests: None declared |
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