FRIDAY, June 20, 2014 (HealthDay News) -- U.S. government
agencies must do more to determine whether treatments are actually
helping veterans suffering from post-traumatic stress disorder
(PTSD), an expert advisory panel contends.
The report from the Institute of Medicine (IOM) committee says
that the effectiveness of PTSD therapies remains unknown because
they are not tracked by the Departments of Defense and Veterans
"Given that the DoD and VA are responsible for serving millions
of service members, families and veterans, we found it surprising
that no PTSD outcome measures are used consistently to know if
these treatments are working or not," committee chair Sandro Galea,
professor and chair of the department of epidemiology, Mailman
School of Public Health, Columbia University, said in an institute
Symptoms of PTSD include re-experiencing an event (such as
having a flashback), avoiding people or situations, and being
"hypervigilant" or being startled easily. To be formally diagnosed
with PTSD, a person must have a specific number and type of these
symptoms for at least a month, according to the U.S. National
Institute of Mental Health.
In 2012, the defense department spent $294 million and the VA
spent $3 billion on PTSD care, but there is no way to know if this
money was well used, the panelists said.
"They could be highly effective, but we won't know unless
outcomes are tracked and evaluated," Galea said.
About 5 percent of all service members in the U.S. military
health system have been diagnosed with PTSD, and the rate is 8
percent for those who served in Iraq and Afghanistan, according to
the report, which was ordered by Congress.
The problem is increasing, the IOM noted. The number of veterans
who sought care for PTSD from the VA rose from about 190,000 (4.3
percent of all VA users) in 2003 to more than 500,000 (9.2 percent
of all VA users) in 2012. Among those treated for PTSD by the VA in
2012, nearly 24 percent were veterans of the Iraq and Afghanistan
The defense department and VA offer a number of programs to
prevent, screen for, diagnose and treat PTSD. However, the defense
department's treatment programs appear to be local, improvised and
crisis-driven, with little planning for a long-term approach. The
VA's treatment programs are more unified and consistent, according
to the committee that wrote the report.
Across both agencies, the failure to track results means that
they have no way of knowing if the care they provide is effective,
the report said.
The defense department and VA need to develop, coordinate and
implement a system that documents PTSD patients' progress over the
course of treatment, regardless of where they receive care. They
also need to conduct long-term follow-up with patients, the IOM
The report also said that the defense department and VA need to
have enough mental health care providers to meet the growing demand
for PTSD care. They have substantially increased their mental
health staffing, but this does not appear to have kept pace with
the demand for PTSD services.
In 2013, only 53 percent of veterans of the Iraq and Afghanistan
wars who were diagnosed with PTSD and sought VA care had received
the recommended eight treatment sessions within 14 weeks, the
Among the other findings: The number of PTSD cases is rising among veterans of earlier
wars. In 2013, the VA diagnosed more than 62,500 new cases of PTSD
in veterans who did not serve in the Iraq and Afghanistan wars, and
Vietnam War veterans made up 34 percent of new patients admitted to
VA specialized PTSD programs in 2012.PTSD is the third most common major military service-related
disability after hearing loss and ringing in the ears
(tinnitus).In 2012, 13.5 percent of soldiers in the U.S. Army had a
diagnosis of PTSD, as did 10 percent of Marines, 4.5 percent of
Navy personnel, and 4.4 percent of Air Force personnel.
The U.S. National Library of Medicine has more about