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Health Matters: Hope for post-traumatic stress sufferers

Q. I know that PTSD is a big problem. I heard about some promising new treatment recently. What's the story? A. Post-traumatic stress disorder (PTSD) is a common and often devastating psychiatric disease that affects some people after exposure to...

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Q. I know that PTSD is a big problem. I heard about some promising new treatment recently. What's the story?

A. Post-traumatic stress disorder (PTSD) is a common and often devastating psychiatric disease that affects some people after exposure to extreme stress, especially soldiers who experienced a combat environment. As many as one in 10 people have manifestations of PTSD, and the frequency is even higher in active-duty soldiers. People with PTSD seem to be "wired" and "hyper." They typically have trouble getting to sleep and staying asleep, and often are tormented by sleep disorders and flashbacks. Many PTSD sufferers report that if they could just get back to a normal sleep pattern that they'd feel much better. A major clinical trial was just reported where a medication was used to counter the hyperarousal seen in PTSD, and its effects were compared with those of a sugar pill (placebo). Unfortunately, the study was a negative one-the medication was of no benefit in reducing upsetting dreams or improving sleep quality in over 300 PTSD sufferers when compared with the placebo. So there is bad news and good news in this study-the bad news is that the medication didn't work, but the good news is that the study will stimulate other trials of medications to treat this common health disorder.

Q. I know that we spend a lot of money on health care in this country, but I was surprised to learn that despite all the money we spend, our health outcomes for infants and children actually are worse than other developed countries. Please help me understand this paradox!

A. You've hit the nail on the head-we spend more than any other country on health care, and yet, somewhat counterintuitively, our health outcomes are not always the best. Nowhere is this more apparent than with infant and childhood mortality, where we've fared worse than any other developed country on earth for the past 50 years! The obvious explanation-that despite how much we spend, our health care system just isn't up to snuff compared with other countries-turns out to be wrong. When we look at diseases like infections, heart and vascular ailments, cancer, and psychiatric disorders, our outcomes are identical to those seen in other developed countries. But our children are much more likely to die from intentional or unintentional accidental death, often caused by injuries, and infants are more likely to die due to problems associated with premature birth and low birth weight. And while worldwide mortality rates for infants and children have fallen dramatically over the past five decades, the U.S. continues to lead the rest of the developed world in this area-not a statistic that we should be proud of! So while our higher-than-desired infant and child mortality rate continues to be an issue, it's not one that we can blame solely-or even predominantly-on our health care delivery system, which while expensive still is outstanding. If we want to make a real impact on our less-than-optimal numbers, we'll need to address injuries (including those suffered in auto accidents), and premature birth/low birth weight, which often are associated with more impoverished populations.

Wynne is vice president for health affairs at UND, dean of the university's School of Medicine and Health Sciences, and a professor of medicine. He is a cardiologist by training.

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Submit a question to Health Matters at  healthmatters@med.und.edu  or Health Matters, 1301 North Columbia Road, Stop 9037, Grand Forks, ND 58202-9037. Remember, no personal details, please.

The content of this column is for informational purposes only and does not substitute for professional medical advice or care. The information provided herein should not be used for diagnosing or treating a health problem or disease. If you have or suspect you may have a health problem, you should consult your health care provider. Never disregard professional medical advice or delay in seeking it because of something you have read in this column.

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