Brain Scan Could be Better Test For PTSD

Rather than argue over whether a 15-minute survey can determine if service members suffer from post-traumatic stress disorder, researchers are trying to find biological ways to make the diagnosis.
by Kelly Kennedy

We’re looking for an objective, independent, biological marker, said Dr. Charles Marmar, who directs the PTSD facility for the San Francisco Office of Veterans Affairs, told the House defense appropriations subcommittee Friday.

The best bet so far is using brain imaging to look for areas of the brain with unusual activity, he said.

But he also had bad news for the committee: Service members with brain injuries are more likely to have PTSD and less likely to be diagnosed with it. And, based on studies from Vietnam, veterans from Iraq and Afghanistan face several grim possibilities if they don’t receive help now.

We’re going to need a lot of psychological help, said Rep. Bill Young, R-Fla., ranking member of the committee. Some of these young guys’ lives will never be the same.

Symptoms include sleeplessness, hyper-awareness such as a continuing need to scan for enemy threats, or drive as if avoiding roadside bombs and emotional numbing…

A physical test could change the stigma of mental health issues. If a brain image could show PTSD, the illness is no longer invisible: The test could make the diagnosis objective because it would not depend on a service member explaining why he’s sick.

Marmar said if the service members don’t get help immediately, they could face bleak futures.

Of those who served in theater during the Vietnam War, one-third developed PTSD. Half of the men and one-third of the women still had it 10 years or more after leaving the combat zone and most had not sought help.

If you have it for one year or longer, you have a 50 percent chance of having it five years later, he said. They need early and aggressive treatment.

Marmar said Iraq veterans need face-to-face exit interviews that take about two hours with trained counselors to receive a proper diagnosis. He recommended pre-deployment, deployment and post-deployment screening.

We recognized that early on, said Rep. John Murtha, D-Penn. We can’t get it done.

A major issue with the wars in Iraq and Afghanistan is that after months away from their families, most troops just want to go home; they’re not interested in spending any time in a treatment facility working on their mental health issues.

But Marmar said recent studies have shown hope beyond a physical proof of the disease. First, counseling may work just as well over the phone as it does face to face, and phone counseling has a lower dropout rate because service members like the convenience. Second, service members may be able to get the help they need through counseling over the Internet.

OIF and OEF veterans like computers, Marmar said. The Internet could help.