Post-traumatic stress disorder: medicine and politics

Date
2007
Authors
Stein D.J.
Seedat S.
Iversen A.
Wessely S.
Journal Title
Journal ISSN
Volume Title
Publisher
Abstract
Regrettably, exposure to trauma is common worldwide, and can have serious adverse psychological results. The introduction of the notion of post-traumatic stress disorder has led to increasing medicalisation of the problem. This awareness has helped popular acceptance of the reality of post-traumatic psychiatric sequelae, which has boosted research into the pathogenesis of the disorder, leading to improved pharmacological and psychological management. The subjective experience of trauma and subsequent expression of symptoms vary considerably over space and time, and we emphasise that not all psychological distress or psychiatric disorders after trauma should be termed post-traumatic stress disorder. There are limits to the medicalisation of distress and there is value in focusing on adaptive coping during and after traumas. Striking a balance between a focus on heroism and resilience versus victimhood and pathological change is a crucial and constant issue after trauma for both clinicians and society. In this Review we discuss the advantages and disadvantages of medicalising trauma response, using examples from South Africa, the Armed Services, and post-disaster, to draw attention to our argument. © 2007 Elsevier Ltd. All rights reserved.
Description
Keywords
4 aminobutyric acid receptor, glucocorticoid receptor, hydrocortisone, serotonin uptake inhibitor, alcohol abuse, army, cultural factor, diagnostic and statistical manual of mental disorders, disaster, disease predisposition, disease severity, doctor patient relation, epidemiological data, human, hydrocortisone blood level, hypothalamus hypophysis adrenal system, Iraq, medicine, mental health care, military medicine, model, molecular imaging, monoaminergic system, neuroanatomy, neurobiology, pathogenesis, politics, posttraumatic stress disorder, priority journal, psychobiology, psychopharmacotherapy, psychosis, review, social aspect, South Africa, substance abuse, United States, veteran, Brain, Humans, Politics, Severity of Illness Index, Stress Disorders, Post-Traumatic, Wounds and Injuries
Citation
Lancet
369
9556