Over the past decade, more than two million Americans have deployed to wars in Iraq and Afghanistan where they were routinely exposed to life-threatening events. Such traumas may result in posttraumatic stress disorder (PTSD), a condition marked by intrusive thoughts and memories of traumatic experiences. Common symptoms of PTSD are startle, arousal, and sleep problems that can affect physical and psychological well-being.

Authors suggest that PTSD is a "brain injury" that impairs forgetting. Sufferers often are depressed, or cope with symptoms through substance abuse. In addition, suicide is also a concern.

The authors suggest that military returning from war should be screened for PTSD, and describe the screening tools that are useful in a primary care setting. The authors suggest that this type of "trauma informed" care (care that recognizes and plans for detecting and treating disorders that result after traumatic events) can help all patients.

"Trauma Informed Care for Primary Care: The Lessons of War"

Robert J. Ursano, MD; David M. Benedek, MD; and Charles C. Engel, MD, MPH