Post-traumatic stress disorder among veterans of the war in Iraq

Posttraumatic Stress Disorder (PTSD) is the most common mental health disorder being diagnosed among returning veterans of the conflicts in Iraq and Afghanistan. PTSD is an injury to the nervous system characterized by symptoms of reexperiencing, avoidance, and hyperarousal. These symptoms may severely impact social and occupational functioning and may be profoundly disabling.

The development of PTSD involves complex interactions between biological and environment factors. Biological factors such as genetics, age, and gender affect the likelihood of developing PTSD. Characteristics of traumatic exposures as well as aspects of the pre- and post-deployment environments are also critical factors. Similarities and differences between the war in Iraq and the war in Vietnam will be examined in terms of the propensity for producing PTSD in combatants.

Neuroendocrine studies and functional neuroimaging are among the lines of investigation that have begun to reveal the psychopathology of PTSD. Alterations in stress hormone systems and the neurocircuitry of fear responses will be described. An overview of psychopharmacologic and psychotherapeutic strategies for treating PTSD will be presented.

Beyond the effects of war on individuals, the societal costs of PTSD are profound., including family violence, divorce, and unemployment. The financial burden extends to lost wages and lost productivity in addition to lifetime costs of mental health treatment and disability payments to affected veterans. Estimates of these costs from the current conflicts for the United States alone run in the hundreds of billions of dollars.