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ATLANTA -- Soldiers wounded in Iraq and Afghanistan are no more likely than uninjured soldiers to have post-traumatic stress disorder (PTSD) a few months after leaving the battlefield, suggests a study released Wednesday, the first on injured soldiers' mental health.
"It was surprising to us. It's a 'good news' story," says psychiatrist Thomas Grieger of the Uniformed Services University of the Health Sciences in Bethesda, Md. He reported on 613 soldiers admitted to Walter Reed Army Medical Center at the American Psychiatric Association meeting here.
The PTSD symptom tests, which were given a month after soldiers were wounded, did not identify about four out of five who later developed the disorder. On the other hand, about half with symptoms soon after injury recovered in a couple of months, the study shows. The percentage of injured soldiers with the disorder after six months was about the same as was reported last year for all combat troops.
That does not mean it's the final rate, says psychologist Christopher Frueh, director of the PTSD clinic at the Veterans Affairs Medical Center in Charleston, S.C. "It could rise later as more try to work. We just don't know."
The symptoms checklist misclassifies 10% to 20% "either way," he adds. A standardized interview with a mental health professional "is the gold standard" to determine the real rate, Frueh says.
The low rates of post-traumatic stress a month after injury might be because soldiers do not yet realize the seriousness of their injuries, Grieger says. They also received intensive mental health treatment at Walter Reed, he says.
The rates could go up later , when "they may have a wife driving them around because they don't have a car that accommodates their amputation, or their pain hasn't receded like they thought it would," Grieger says.
The Army is rolling out a program of mental health screenings for all deployed soldiers, Grieger says.
Not everyone says it's a good idea. "This is valuable research, but there's no evidence that screening improves the outcome for soldiers," says psychiatrist Simon Wessely, director of King's Center for Military Health Research at King's College in London.
Wessely says many recover with no treatment, and others feel unfairly labeled. Also, fear of stigma keeps many combat soldiers from seeking help. "Our first priority should be that everyone who actually wants help gets the best."
Says Frueh: "Many of our (VA) mental health clinics are swamped, though not many from Iraq have come in yet." Community vets' centers also offer counseling. Says Grieger: "We can encourage them to get help, but we can't force them."
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