Post-traumatic stress disorder: medicine and politics

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dc.contributor.authorStein D.J.
dc.contributor.authorSeedat S.
dc.contributor.authorIversen A.
dc.contributor.authorWessely S.
dc.date.accessioned2011-05-15T15:57:03Z
dc.date.available2011-05-15T15:57:03Z
dc.date.issued2007
dc.description.abstractRegrettably, 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.
dc.description.versionReview
dc.identifier.citationLancet
dc.identifier.citation369
dc.identifier.citation9556
dc.identifier.issn1406736
dc.identifier.other10.1016/S0140-6736(07)60075-0
dc.identifier.urihttp://hdl.handle.net/10019.1/10183
dc.subject4 aminobutyric acid receptor
dc.subjectglucocorticoid receptor
dc.subjecthydrocortisone
dc.subjectserotonin uptake inhibitor
dc.subjectalcohol abuse
dc.subjectarmy
dc.subjectcultural factor
dc.subjectdiagnostic and statistical manual of mental disorders
dc.subjectdisaster
dc.subjectdisease predisposition
dc.subjectdisease severity
dc.subjectdoctor patient relation
dc.subjectepidemiological data
dc.subjecthuman
dc.subjecthydrocortisone blood level
dc.subjecthypothalamus hypophysis adrenal system
dc.subjectIraq
dc.subjectmedicine
dc.subjectmental health care
dc.subjectmilitary medicine
dc.subjectmodel
dc.subjectmolecular imaging
dc.subjectmonoaminergic system
dc.subjectneuroanatomy
dc.subjectneurobiology
dc.subjectpathogenesis
dc.subjectpolitics
dc.subjectposttraumatic stress disorder
dc.subjectpriority journal
dc.subjectpsychobiology
dc.subjectpsychopharmacotherapy
dc.subjectpsychosis
dc.subjectreview
dc.subjectsocial aspect
dc.subjectSouth Africa
dc.subjectsubstance abuse
dc.subjectUnited States
dc.subjectveteran
dc.subjectBrain
dc.subjectHumans
dc.subjectPolitics
dc.subjectSeverity of Illness Index
dc.subjectStress Disorders, Post-Traumatic
dc.subjectWounds and Injuries
dc.titlePost-traumatic stress disorder: medicine and politics
dc.typeReview
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