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Mark Levy, MD "Stressing the Point: Post Traumatic Stress Disorder Claims," For the Defense, 1995
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Essentials of Litigating Post Traumatic Stress Disorder Claims (PowerPoint Slide Presentation)
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PTSD: Diagnosis & Treatment of Trauma and Stress - Read an Audiograph Booklet and Watch a Multimedia Presentation from Journal of Clinical Psychiatry (up to 2 hours CME credit available) - click to view
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Review Article: Psychopharmacologic Treatment of PTSD (Nov-Dec 2002)
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Research: Understanding PTSD Takes On Urgency in Wake of September 11
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The Lasting Effects of Psychological Trauma on Memory and the Hippocampus
- Relationship of PTSD to Hippocampal Size:
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...personal
communication from Michael Weiner, MD, Professor
in Residence of Radiology,
School of Medicine, University of California, San Francisco.
Relationship of PTSD to Hippocampal Size
- There are at least 5 published studies showing that patients with PTSD have reduced size of the hippocampus. However, the reductions of hippo volume are only in the order of 5-20%. Therefore, whenever a group of PTSD subjects is compared to a group of controls, there is a lot of overlap between subjects.
- If any study were to be performed, it would be a MRI and possible a MRS of the hippocampus. If the patient had reductions at least 1 ( better 2 ) Standard deviation below the mean, this would be consistant with brain injury secondary to PTSD. But remember, many PTSD patients have no or only very minor reductions of hippocampal size. For exactly this reason, nobody has suggested that MRI or MRS ( or any other biological test) can be used to diagnose or evaluate severity of PTSD. Certainly, the VA which pays many millions in compensation for ptsd would be very interested if such a test were available... but none of us have suggested using it.
- Ref.
Schuff, N., Marmar, C.R., Weiss, D.S., Neylan, T.C., Schoenfeld, F.,
Fein, G., and Weiner, M.W.: Reduced hippocampal volume and n-acetylaspartate
in post traumatic stress disorder. In: The Annals of the New
York Academy of Sciences. Supplement on Psychobiology of Posttraumatic
Stress Disorder 821:516-520, 1997.
News! Two interesting articles on the psychopathology of individual differences in susceptibility PTSD may be found at
IN REVIEW Individual Differences in Posttraumatic Distress: Problems With the DSM-IV Model
http://cpa.medical.org/arc/pubs/journal/1999/feb/bowman.htm
and
Biological Factors Associated With Susceptibility to Posttraumatic Stress Disorder
http://cpa.medical.org/arc/pubs/journal/1999/feb/yehuda.htm
- (click to read and for printable pdf version...)
-
...personal
communication from Michael Weiner, MD, Professor
in Residence of Radiology,
School of Medicine, University of California, San Francisco.
Original PTSD Articles by Mark I. Levy MD, FAPA:
- Deposing Mental Health Experts on Post-Traumatic Stress Disorder (PTSD) Rosenberg, Saul and Levy, Mark, Chapter 716, Lawyers' Guide to Medical Proof, Volume 4 edited by Marshall Houts, J.D., LexisNexis Mathew Bender, 2002
- Stressing the Point:When is a Post Traumatic Stress Disorder Claim Legitimate...and When Is It Not? Mark I. Levy, M.D., F.A.P.A., November 1995 issue of For the Defense, the monthly journal of the Defense Research Institute, Chicago, Illinois.
Links to Selected PTSD Bibliography:
- PTSD Fact Sheet (pdf file)
- PTSD Memory and Brain Effects (pdf file)
- PTSD and Domestic Violence (pdf file)
- Costs of PTSD (pdf file)
- Costs of Workplace Stress (pdf file)
(PTSD and brain imaging)
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© 2000Mark I. Levy, MD, FAPA