Previous studies of the mental health effects of combat have generally been conducted years (or even decades) after service members returned home. The current war in Iraq and Afghanistan is unique in the amount of research that has been conducted on the mental health effects of combat as the war has been ongoing, to include population-based health services research. Various studies have shown that up to one-third of service members in ground combat units experience significant symptoms of post-traumatic stress disorder (PTSD), depression, anxiety, alcohol misuse, or family problems resulting in referral for mental health treatment. The ongoing research has led directly to new population-based health care policies to include post-deployment mental health assessments, program evaluation, and new efforts to reduce stigma. However, despite these efforts, over half of service members with serious mental health concerns do not receive treatment, and stigma remains pervasive. In addition, there has been increasing concern about mild traumatic brain injuries related to exposure to blast explosions, and the overlap between mild TBI and PTSD. This talk will discuss the lessons learned about PTSD and mild TBI among Iraq and Afghanistan war veterans from an epidemiological perspective, to include discussion of current issues and controversies.
Charles W. Hoge is a Colonel in the U.S. Army Medical Corps. He originally trained in internal medicine and infectious diseases. From 1989-1991, he served in the U.S. Public Health Service as an EIS (Epidemiology Intelligence Service) officer at Centers for Disease Control, where he learned epidemiology and led several infectious disease outbreak investigations. He switched from USPHS to the Army in 1991, and spent the next six years, including four years in Thailand, conducting numerous field studies related to the treatment and prevention of tropical infections that affect U.S. soldiers deployed to developing countries. In 1997, he had a career change to psychiatry and completed his residency in psychiatry at Walter Reed Army Medical Center in 2000. For the last seven years COL Hoge has led a psychiatric research program at Walter Reed Army Institute of Research (WRAIR) focused on mitigating the mental health impact of the current wars in Iraq and Afghanistan. He has over 70 peer-reviewed publications, including lead articles on his current research in JAMA (March 2006 and November 2007) and New England Journal of Medicine (July 2004).
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