- N Engl J Med 2022; 387:102-105
Appropriately, Russia’s war of aggression in Ukraine has prompted a massive humanitarian response — but the assault has intensified and time is running out.
- N Engl J Med 2022; 386:2233-2234
A century after “the war to end all wars,” we continue to find our human community divided by conflict and our military service members at the leading edge. The ghostly scars of shell shock, later termed post-traumatic stress disorder (PTSD), have haunted generations of soldiers, as well as civilian survivors...
- N Engl J Med 2022; 386:2169-2177
Microscopic and immunohistochemical examination revealed chronic traumatic encephalopathy in 10 of 225 brains (4.4%) from a military brain bank. The relative risks of CTE were calculated for exposure to blasts, traumatic brain injury, and previous participation in contact sports.
- N Engl J Med 2022; 386:2067-2069
Black girls in America are harmed by intersecting racism and sexism, which manifest in biases, stereotypes, and practices that render them vulnerable to abuse, dehumanization, and death. Our silence about Black girls has clinical consequences throughout their life span.
- N Engl J Med 2022; 386:1950-1952
A recent study of mouse models implicates dopaminergic nerve terminals in the amygdala in releasing the brakes on rapid-eye-movement sleep and on cataplexy in a mouse model of narcolepsy. REM sleep is believed to have a role in processing emotional memories and is under investigation in persons with post-traumatic stress...
- N Engl J Med 2021; 384:e99
Actions by the Biden administration to end harmful immigration policies are critically important. But solutions should also include creating conditions within the United States that will allow children exposed to immigration-related trauma to grow, learn, and thrive.
A Half-Century of Progress in Health: The National Academy of Medicine at 50: Shaping the Future of Veterans’ Health CareN Engl J Med 2020; 383:1801-1804
Members of the U.S. military are at risk for a range of combat-related injuries and hazardous exposures, and some chronic health problems can arise years after service. Although there have been important advances in our ability to care for veterans, challenges remain.
- N Engl J Med 2020; 383:1058-1065
A 64-year-old man was evaluated at the geriatric psychiatry clinic for chronic depression, intrusive thoughts, and fear of being poisoned. The patient grew up in Haiti, where he, his siblings and relatives, and many community members observed Vodou and Santeria beliefs and practiced tarot card reading. Diagnostic and management decisions...
- N Engl J Med 2020; 383:513-515
Just as the country rallied to care for September 11 first responders who suffered long-term health effects, we must take responsibility for the well-being of clinician first responders to Covid-19 — now and in the long run. Five high-priority actions can help to protect health care workers.
- N Engl J Med 2020; 382:2557-2565
A 7-year-old girl who had immigrated to the United States from Central America was evaluated in the asylum clinic because of psychological distress after detainment and family separation while crossing the U.S.–Mexico border. The patient and her mother had been reunited 2 months after detainment. Management decisions were made.
Case Studies in Social Medicine: Biological Citizenship — A 53-Year-Old Man with Schizoaffective Disorder and PTSD Applying for Supplemental Security IncomeN Engl J Med 2019; 381:1985-1989
A man with multiple mental health conditions stops attending the clinic where he received wrap-around services. Denied Supplemental Security Income because his psychiatrist had documented his improvement, he had ceased taking his medications and ended up hospitalized.
- N Engl J Med 2019; 380:807-809
A New Jersey detention center houses asylum seekers who have fled persecution in their home countries. Even the U.S. physician who comes to examine them must tread carefully to be allowed to do her job in this loud, gray place where guards’ decisions seem arbitrary.
- N Engl J Med 2019; 380:178-185
A 34-year-old male war veteran was evaluated at this hospital for headaches, cognitive changes, mood symptoms, flashbacks, chest pain, arm tingling, and gastrointestinal symptoms. Examination and laboratory testing were unrevealing. A diagnosis was made.
- N Engl J Med 2019; 380:5-7
As part of an ongoing effort to deter immigrants from attempting to enter the United States, a new government proposal would permit the detention of noncitizen children and their families for indefinite periods in facilities without appropriate and independent monitoring.
- N Engl J Med 2018; 379:2094-2095
Stories of abuse, of trauma inflicted by people with power, have permeated a primary care physician’s sessions with patients over recent weeks. Many patients name the Kavanaugh hearings as a source of dread: the news has brought back memories of their own experiences.
- N Engl J Med 2018; 379:2093-2094
Patients reveal their most personal and painful life experiences when we build trusting relationships and encourage open dialogue. But how can we encourage the dialogue required for trauma-informed care in today’s health care climate?
- N Engl J Med 2018; 378:507-517
In a trial involving 304 veterans with stable PTSD, prazosin did not alleviate distressing dreams and did not improve sleep quality or overall clinical symptoms over 10 or 26 weeks. This result is in contrast to findings in several previous smaller or briefer trials.
- N Engl J Med 2018; 378:575-576
Post-traumatic stress disorder (PTSD) is a debilitating, common, and sometimes deadly psychiatric condition that occurs in the aftermath of extremely distressing and life-threatening exposure to trauma. PTSD is found in 5 to 10% of the U.S. population, and the percentage is even higher in special populations that have been exposed...
- N Engl J Med 2017; 377:1804-1806
Extreme events often cast in bold relief what we do and don’t know about medicine and public health. In recent weeks, Hurricanes Harvey, Irma, and Maria have illuminated our knowledge gaps regarding the consequences of disasters and their mitigation.
- N Engl J Med 2017; 376:2459-2469
PTSD is characterized by the persistence of intense reactions to reminders of a traumatic event, altered mood, a sense of imminent threat, disturbed sleep, and hypervigilance. Cognitive behavioral therapy and anxiolytic or antidepressant agents can ameliorate symptoms.