Pain, Depression, and Posttraumatic Stress Disorder Following Major Extremity Trauma Among United States Military Serving in Iraq and Afghanistan: Results From the Military Extremity Trauma and Amputation/Limb Salvage Study.

Objectives: Assess the burden and co-occurrence of pain, depression, and posttraumatic stress disorder (PTSD) among service members who sustained a major limb injury, and examine whether these conditions are associated with functional outcomes.

Design: A retrospective cohort study.

Setting: Four U.

Non-organic Vision Loss in the Afghanistan and Iraq Conflicts.

Non-organic visual loss (NOVL), defined as a decrease in visual acuity or field without an identifiable organic cause, can be challenging to diagnose, especially in patients whose NOVL is superimposed on some component of true organic pathology. Exposure to combat puts soldiers at risk of emotional distress and physical trauma, which can contribute to the development of NOVL with conversion disorder or malingering. This case series describes six patients with NOVL who sustained ocular or non-ocular injuries while serving in combat operations in Iraq and Afghanistan, and highlights diagnostic pearls and components of inter-disciplinary management in the unique military context.

The Military Extremity Trauma Amputation/Limb Salvage (METALS) study: outcomes of amputation versus limb salvage following major lower-extremity trauma.

Background: The study was performed to examine the hypothesis that functional outcomes following major lower-extremity trauma sustained in the military would be similar between patients treated with amputation and those who underwent limb salvage.

Methods: This is a retrospective cohort study of 324 service members deployed to Afghanistan or Iraq who sustained a lower-limb injury requiring either amputation or limb salvage involving revascularization, bone graft/bone transport, local/free flap coverage, repair of a major nerve injury, or a complete compartment injury/compartment syndrome. The Short Musculoskeletal Function Assessment (SMFA) questionnaire was used to measure overall function.

A dissociative episode following stage hypnosis in a combat-injured soldier: implications, treatment and reflections.

Significant data to suggest the need for more appropriate precautions for volunteers participating in stage hypnosis is presented. This paper is a case report of a soldier previously injured in battle who, due to participating in stage hypnosis one year after his injury, experienced a dissociative episode wherein post-traumatic stress symptoms were prominent. During this episode, which lasted over three hours, the service member assaulted an acquaintance, subsequently believed he was a prisoner of war, experienced amnesia for some of the events, and was eventually psychiatrically hospitalized.

Psychodynamic concepts inherent in a biopsychosocial model of care of traumatic injuries.

The psychological issues facing medical and surgical patients suffering from traumatic injuries are numerous and varied. These injuries may occur in the settings of armed conflict, terrorist attack, natural disaster, or accident. The goal of preventing or decreasing significant and disabling psychiatric comorbidity can be the objective and assignment of a Psychiatry Consultation Liaison Service (PCLS) within the hospital setting.

Posttraumatic stress disorder and depression in battle-injured soldiers.

Objective: This study examined rates, predictors, and course of probable posttraumatic stress disorder (PTSD) and depression among seriously injured soldiers during and following hospitalization.

Method: The patients were 613 U.S.

Reflections on hypnotizability and its impact on successful surgical hypnosis: a sole anesthetic for septoplasty.

While hypnosis has been a significant medical tool through the ages, its use has been, at best, capricious. After the development and widespread use of ether, hypnosis has been mostly relegated to the role of an adjunct to chemical anesthesia. The present paper describes a case where hypnosis was used as the sole anesthetic for a septoplasty.

Meeting the patients where they are: consultation-liaison response to trauma victims of the Pentagon attack.

The Psychiatry Consultation-Liaison Service at Walter Reed Army Medical Center provided an immediate mental health response to hospitalized victims of the Pentagon attack on September 11. This article reviews our experience with this population and the lessons learned. Successful intervention required a flexible and innovative approach that included export of our services to the patient's location, liaison with involved facilities and treatment teams, and modification of therapeutic contact.