DOCSLIB.ORG

Post Traumatic Stress Disorder Myths and Realties

Total Page：16

File Type：pdf, Size：1020Kb

Download full-text PDF Read full-text
Post Traumatic Stress Disorder Myths and Realties Post Traumatic Stress Disorder Myths and Realties West Virginia Offices of the Insurance Commissioner May 9, 2019 David A. Clayman, Ph.D. Clinical, Medical and Forensic Psychologist PTSD • Long history – RELATED TO BATTLE – 480 B.C.: Spartan commander Leonidas dismissed emotionally and psychologically spent soldiers from battle. – 1678: Symptoms described by Swiss military physicians. • First officially identified as a “mental disorder” in 1980 in the DSM-III. – Included non-combat events Defining TRAUMA • DSM-III: An event beyond the range of normal that would be distressing for anyone who experienced it (1980) • DSM-IV: An event that can cause serious injury, harm or death but not necessarily beyond the range of normal. (1994) • DSM-IV-TR: Redefined trauma to include events that cause intense fear, helplessness and horror. (2000) Acute Stress Disorder DSM-5 (2013) – The stressor criterion requires being explicit as to whether qualifying traumatic events were experienced directly, witnessed, or experienced indirectly. – Typically begin immediately after exposure to the trauma lasting for at least 3 days up to a month. – The disturbance causes clinically significant distress or impairment in social, occupational, or other important areas of functioning. PTSD DSM-5 (2013) Necessitates exposure to actual or threatened death, serious injury, or sexual violence in one or more defined ways. 1. Directly experiencing the traumatic event(s). 2. Witnessing, in person, the event (s) as it occurred to others. 3. Learning that the traumatic event(s)occurred to a close family member or). In cases of actual or threatened death of a family member or friend, the event(s) must’ve been violent or accidental. 4. Experiencing repeated or extreme exposure to aversive details of the traumatic event(s) (e.g., first responders collecting human remains; police officers repeatedly exposed to details of child abuse.) PTSD DSM-5 (2013) Requires presence of symptoms from 4 different categories with symptoms starting after the index event: Intrusive symptoms associated with the traumatic event(s) [≥1/5]. Persistence avoidance of stimuli associated with traumatic event(s) [≥1/2]. Negative alterations in cognitions and mood associated with the traumatic event(s) [≥2/7] Marked alterations in arousal and reactivity associated with the traumatic event(s) [≥2/6] PTSD DSM-5 (2013) Duration of the disturbance is more than one month. May have delayed onset. May include other qualifiers. *** Should be familiar with the cautionary statement for forensic use of the DSM-5. PTSD • Scope has expanded to include non-combat stressors. • Consideration made of emotional-psychological presentations that do not meet the complete criteria. • Distinction being made between PTSD and Complex PTSD (prolonged, repeated trauma causing behavioral disturbance). • Lots of room for differing perspectives in spite of efforts to be explicit in defining criteria for diagnosis. • Diagnosis is necessary but not sufficient! Myths about PTSD PTSD is a sign of mental weakness. Anything can be traumatic. You can get PTSD immediately after experiencing a trauma. People with PTSD are crazy and/or dangerous. People with PTSD cannot function in military or work environments. After a while, people with PTSD suggest be able to get over it. Myths about PTSD (cont.) Veterans with PTSD are not “wounded.” Nothing can be done for those who have PTSD. Trauma and conditions like PTSD only impact people have had a near-death experience. Strong people can deal with trauma on their own and don’t need help. Realities about PTSD • An estimated 70 percent of adults in the United States have experienced a traumatic event at least once in their lives and up to 20 percent (14%) of these people go on to develop posttraumatic stress disorder, or PTSD. • An estimated 5 percent of Americans—more than 13 million people—have PTSD at any given time. • Approximately 8 percent of all adults—1 of 13 people in this country—will develop PTSD during their lifetime. • An estimated 1 out of 10 women will get PTSD at some time in their lives. Women are about twice as likely as men to develop PTSD. • Approximately 9% of car accident survivors develop PTSD. Workers’ Compensation and PTSD • West Virginia implicitly rejects the idea of a standalone claim for PTSD. • Physically injured individuals have made add- on claims for PTSD. • Often rely on statements by treating clinicians to determine whether an individual meets the diagnostic criteria for PTSD related to the claimant’s physical injury or even a standalone condition. Workers’ Compensation and PTSD Close but no Cigar • 2019 West Virginia Legislature SB 114. – allowing workers’ compensation benefits for first responders diagnosed with post-traumatic stress disorder resulting from an event that occurred during their employment. – Law Enforcement Officers (≈10%), Firefighters (≈ 20%)and Medical First Responders (≈10%) considered high risk careers. • LEO and EMT likely low estimates. • Higher in disaster response circumstances(15-30%). Health and Anxiety Disorders • The annual cost to society of anxiety disorders is estimated to be significantly over $42.3 billion, often due to misdiagnosis and under treatment. This includes psychiatric and non- psychiatric medical treatment costs, indirect workplace costs, mortality costs, and prescription drug costs. Diagnostic Issues • Changing criteria. • TRAUMA ≠ ANYTHING BAD/UPSETTING • Many bad things happen to people, affecting them deeply, that are not “trauma.” • Diagnosis often rendered by treating clinician who relies on subjective report of patient/client. • WC should rely on objective, qualified evaluators (forensically trained psychologists and psychiatrists). Identifying…Diagnosing…Treating • Misdiagnosis is common • Misunderstandings are common • Great reason not to focus on other issues • Serious but treatable when it is present • Typically NOT present alone – Substance Abuse – Depression Differential Diagnoses • Mental disorder secondary to GMC – (ex. head injury) • Substance-induced disorder • Dissociative disorders • Other anxiety disorders • Major depressive episode • Borderline personality disorder • Malingering • Litigation Points to Remember…not simple. • If a patient has multiple complaints, think PTSD or personality disorder up front. • Under-detected because we don’t ask the right questions. • One of the few DSM disorders defined by it’s cause! Treatment: PTSD • Requires multiple modalities • Initial education, support and referrals important to establish trust • Pharmacotherapy • Psychotherapy • Relaxation Training • And more…. The Course of PTSD • The symptoms and the relative predominance of re- experiencing, avoidance, and increased arousal symptoms may vary over time. • Duration of symptoms also varies: Complete recovery occurs within 3 months after the trauma in approximately half of the cases. Others can have persisting symptoms for longer than 12 months after the trauma. • Symptom reactivation may occur in response to reminders of the original trauma, life stressors, or new traumatic events. The Course of PTSD (cont.) • The severity, duration, and proximity of an individual’s exposure to a traumatic event are the most important factors affecting the likelihood of developing PTSD. • Social supports, family history, childhood experiences, personality variables, and pre-existing mental disorders may influence the development of PTSD. • PTSD can also develop in individuals without any predisposing conditions, particularly if the stressor is extreme. • The disorder may be especially severe or long lasting when the stressor is of human design (torture, rape). References (Have used these numerous sources and combined information.) • https://psychcentral.com/disorders/ptsd/posttraumatic-stress-disorder- ptsd-facts/ • https://deserthopetreatment.com/ptsd-substance-abuse/high-risk- professions/ • https://www.betterhelp.com/advice/ptsd/the-facts-and-fictions-of-ptsd- statistics/ • https://www.nimh.nih.gov/health/statistics/post-traumatic-stress- disorder-ptsd.shtml • http://www.ptsdunited.org/ptsd-statistics-2/ • https://downtownlalaw.com/practice-areas/workplace-injury/post- traumatic-stress-disorder-workplace-injury/ • https://www.hartgrovehospital.com/five-myths-and-five-facts-about- ptsd/ • https://www.sidran.org/resources/for-survivors-and-loved-ones/post- traumatic-stress-disorder-fact-sheet-2/ Power Point Authors • Karen Krinsley, Ph.D., PTSD Section Chief, VA Boston Healthcare System & PTSD Consultant, National Center for PTSD • Louise Burkhart, Jaime Hamm, Jessica Mungro & Erin Schultz • Anita S. Kablinger MD, Associate Professor, Departments of Psychiatry and Pharmacology, LSUHSC-Shreveport Thanks David A. Clayman, Ph.D. Clayman & Associates, PLLC. 1097 Fledderjohn Road, Suite 3 Charleston, WV 25314 (p) 304.345.0880 (f) 304.345.1112 [email protected].
Load more

Recommended publications
  • Recognizing When a Child's Injury Or Illness Is Caused by Abuse
    U.S. Department of Justice Office of Justice Programs Office of Juvenile Justice and Delinquency Prevention Recognizing When a Child’s Injury or Illness Is Caused by Abuse PORTABLE GUIDE TO INVESTIGATING CHILD ABUSE U.S. Department of Justice Office of Justice Programs 810 Seventh Street NW. Washington, DC 20531 Eric H. Holder, Jr. Attorney General Karol V. Mason Assistant Attorney General Robert L. Listenbee Administrator Office of Juvenile Justice and Delinquency Prevention Office of Justice Programs Innovation • Partnerships • Safer Neighborhoods www.ojp.usdoj.gov Office of Juvenile Justice and Delinquency Prevention www.ojjdp.gov The Office of Juvenile Justice and Delinquency Prevention is a component of the Office of Justice Programs, which also includes the Bureau of Justice Assistance; the Bureau of Justice Statistics; the National Institute of Justice; the Office for Victims of Crime; and the Office of Sex Offender Sentencing, Monitoring, Apprehending, Registering, and Tracking. Recognizing When a Child’s Injury or Illness Is Caused by Abuse PORTABLE GUIDE TO INVESTIGATING CHILD ABUSE NCJ 243908 JULY 2014 Contents Could This Be Child Abuse? ..............................................................................................1 Caretaker Assessment ......................................................................................................2 Injury Assessment ............................................................................................................4 Ruling Out a Natural Phenomenon or Medical Conditions
    [Show full text]
  • Bipolar Disorder in ADULTS the Disorder, Its Treatment and Prevention
    Bipolar lidelse hos voksne, engelsk Information about BIPOLAR DISORDER IN ADULTS The disorder, its treatment and prevention Psykiatri og Social psykinfomidt.dk CONTENTS 03 What is bipolar disorder? 04 What causes bipolar disorder? 06 What are the symptoms of bipolar disorder? 09 How is bipolar disorder diagnosed? 10 Different progressions and modes of expression 11 How can bipolar disorder be treated and prevented? 14 What can you do to help yourself if you have bipolar disorder? 16 What can your loved ones do? Bipolar affective disorder (the term we will use in this publication is “bipolar disorder”) is a serious mental disorder. When a person has bipolar disorder, knowledge of the illness is important. The more you know, the better you can handle and prevent the illness and its consequences. This brochure describes the illness as well as options for its treatment and prevention. It is mainly intended for people being treated for bipolar disorder by the psychiatric service in Region Midtjylland. We hope this brochure will help you and your loved ones to learn more about the diagnosis of bipolar disorder. Kind regards The psychiatric service in Region Midtjylland Tingvej 15, 8800 Viborg Tel.: 7841 0000 Bipolar disorder in adults WHAT IS BIPOLAR DISORDER? Bipolar disorder is a mental illness lot in terms of reducing the progression characterised by episodes of mania, of symptoms and decreasing the hypomania (a mild form of mania), psychological and social costs to the depression and/or mixed state (a state individual and the family. where manic and depressive symptoms coexist or occur in rapid succession).
    [Show full text]
  • Delayed Traumatic Hemothorax in Older Adults
    Open access Brief report Trauma Surg Acute Care Open: first published as 10.1136/tsaco-2020-000626 on 8 March 2021. Downloaded from Complication to consider: delayed traumatic hemothorax in older adults Jeff Choi ,1 Ananya Anand ,1 Katherine D Sborov,2 William Walton,3 Lawrence Chow,4 Oscar Guillamondegui,5 Bradley M Dennis,5 David Spain,1 Kristan Staudenmayer1 ► Additional material is ABSTRACT very small hemothoraces rarely require interven- published online only. To view, Background Emerging evidence suggests older adults tion whereas larger hemothoraces often undergo please visit the journal online immediate drainage. However, emerging evidence (http:// dx. doi. org/ 10. 1136/ may experience subtle hemothoraces that progress tsaco- 2020- 000626). over several days. Delayed progression and delayed suggests HTX in older adults with rib fractures may development of traumatic hemothorax (dHTX) have not experience subtle hemothoraces that progress in a 1Surgery, Stanford University, been well characterized. We hypothesized dHTX would delayed fashion over several days.1 2 If true, older Stanford, California, USA be infrequent but associated with factors that may aid adults may be at risk of developing empyema or 2Vanderbilt University School of Medicine, Nashville, Tennessee, prediction. other complications without close monitoring. USA Methods We retrospectively reviewed adults aged ≥50 Delayed progression and delayed development of 3Radiology, Vanderbilt University years diagnosed with dHTX after rib fractures at two traumatic hemothorax (dHTX) have not been well Medical Center, Nashville, level 1 trauma centers (March 2018 to September 2019). characterized in literature. The ageing US popula- Tennessee, USA tion and increasing incidence of rib fractures among 4Radiology, Stanford University, dHTX was defined as HTX discovered ≥48 hours after Stanford, California, USA admission chest CT showed either no or ’minimal/trace’ older adults underscore a pressing need for better 5Department of Surgery, HTX.
    [Show full text]
  • Injury Surveillance Guidelines
    WHO/NMH/VIP/01.02 DISTR.: GENERAL ORIGINAL: ENGLISH INJURY SURVEILLANCE GUIDELINES Edited by: Y Holder, M Peden, E Krug, J Lund, G Gururaj, O Kobusingye Designed by: Health & Development Networks http://www.hdnet.org Published in conjunction with the Centers for Disease Control and Prevention, Atlanta, USA, by the World Health Organization 2001 Copies of this document are available from: Injuries and Violence Prevention Department Non-communicable Diseases and Mental Health Cluster World Health Organization 20 Avenue Appia 1211 Geneva 27 Switzerland Fax: 0041 22 791 4332 Email: [email protected] The content of this document is available on the Internet at: http://www.who.int/violence_injury_prevention/index.html Suggested citation: Holder Y, Peden M, Krug E et al (Eds). Injury surveillance guidelines. Geneva, World Health Organization, 2001. WHO/NMH/VIP/01.02 © World Health Organization 2001 This document is not a formal publication of the World Health Organization (WHO). All rights are reserved by the Organization. The document may be freely reviewed, abstracted, reproduced or translated, in part or in whole, but may not be sold or used for commercial purposes. The views expressed in documents by named authors are the responsibility of those authors. ii Contents Acronyms .......................................................................................................................... vii Foreword .......................................................................................................................... viii Editorial
    [Show full text]
  • Psychiatric Assessment of Severe Presentations in Autism Spectrum Disorders and Intellectual Disability
    Psychiatric Assessment of Severe Presentations in Autism Spectrum Disorders and Intellectual Disability a,b, b Bryan H. King, MD *, Nina de Lacy, MD , c,d,e Matthew Siegel, MD KEYWORDS Autism Intellectual disability Self-injury Aggression Hyperactivity Psychiatric evaluation KEY POINTS Psychiatric illnesses are common in autism spectrum disorder (ASD)/intellectual disability (ID). Externalizing behaviors are common presenting symptoms but are etiologically nonspecific. Genetic conditions associated with ASD/ID may inform medical surveillance as well as potential therapeutics. Co-occurring medical conditions are common in ASD/ID and may contribute to symptom presentation. Environmental factors, for example, change in caregiver or experience of trauma, may be particularly significant in the setting of ASD/ID. INTRODUCTION Decades ago, Sovner and Hurley1 somewhat rhetorically debated whether individ- uals with ID experience affective illness. Although the answer then as now is an un- equivocal yes, uncertainty does remain as to how the presentation of psychiatric Disclosure Statement: B.H. King has received research funding and has served as a consultant for Seaside Therapeutics and Roche. Drs N. de Lacy and M. Siegel report no financial disclosures. a Department of Psychiatry and Behavioral Medicine, Seattle Children’s Autism Center, Seattle Children’s Hospital, Seattle, WA, USA; b Department of Psychiatry and Behavioral Sciences, University of Washington, Seattle, WA, USA; c Developmental Disorders Program, Spring Harbor Hospital, ME, USA; d Tufts University School of Medicine, Boston, MA, USA; e Maine Medical Center Research Institute, ME, USA * Corresponding author. E-mail address: [email protected] Child Adolesc Psychiatric Clin N Am 23 (2014) 1–14 http://dx.doi.org/10.1016/j.chc.2013.07.001 childpsych.theclinics.com 1056-4993/14/$ – see front matter Ó 2014 Elsevier Inc.
    [Show full text]
  • Physical Injury, PTSD Symptoms, and Medication Use: Examination in Two Trauma Types
    Journal of Traumatic Stress February 2014, 27, 74–81 Physical Injury, PTSD Symptoms, and Medication Use: Examination in Two Trauma Types Meghan W. Cody and J. Gayle Beck Department of Psychology, University of Memphis, Memphis, Tennessee, USA Physical injury is prevalent across many types of trauma experiences and can be associated with posttraumatic stress disorder (PTSD) symptoms and physical health effects, including increased medication use. Recent studies suggest that PTSD symptoms may mediate the effects of traumatic injury on health outcomes, but it is unknown whether this finding holds for survivors of different types of traumas. The current study examined cross-sectional relationships between injury, PTSD, and pain and psychiatric medication use in 2 trauma- exposed samples, female survivors of motor vehicle accidents (MVAs; n = 315) and intimate partner violence (IPV; n = 167). Data were obtained from participants at 2 trauma research clinics who underwent a comprehensive assessment of psychopathology following the stressor. Regression with bootstrapping suggested that PTSD symptoms mediate the relationship between injury severity and use of pain medications, R2 = .11, F(2, 452) = 28.37, p < .001, and psychiatric medications, R2 = .06, F(2, 452) = 13.18, p < .001, as hypothesized. Mediation, however, was not moderated by trauma type (ps > .05). Results confirm an association between posttraumatic psychopathology and medication usage and suggest that MVA and IPV survivors alike may benefit from assessment and treatment of emotional distress after physical injury. In a recent year, 45.4 million injury-related visits were re- ical health plays in recovery from injury (van der Kolk, Roth, ported at U.S.
    [Show full text]
  • When Treatment Becomes Trauma: Defining, Preventing, and Transforming Medical Trauma
    Suggested APA style reference information can be found at http://www.counseling.org/knowledge-center/vistas Article 73 When Treatment Becomes Trauma: Defining, Preventing, and Transforming Medical Trauma Paper based on a program presented at the 2013 American Counseling Association Conference, March 24, Cincinnati, OH. Michelle Flaum Hall and Scott E. Hall Flaum Hall, Michelle, is an assistant professor in Counseling at Xavier University and has written and presented on the topic of medical trauma, post- traumatic growth, and wellness for nine years. Hall, Scott E., is an associate professor in Counselor Education and Human Services at the University of Dayton and has written and presented on trauma, depression, growth, and wellness for 18 years. Abstract Medical trauma, while not a common term in the lexicon of the health professions, is a phenomenon that deserves the attention of mental and physical healthcare providers. Trauma experienced as a result of medical procedures, illnesses, and hospital stays can have lasting effects. Those who experience medical trauma can develop clinically significant reactions such as PTSD, anxiety, depression, complicated grief, and somatic complaints. In addition to clinical disorders, secondary crises—including developmental, physical, existential, relational, occupational, spiritual, and of self—can lead people to seek counseling for ongoing support, growth, and healing. While counselors are central in treating the aftereffects of medical trauma and helping clients experience posttraumatic growth, the authors suggest the importance of mental health practitioners in the prevention and assessment of medical trauma within an integrated health paradigm. The prevention and treatment of trauma-related illnesses such as post-traumatic stress disorder (PTSD) have been of increasing concern to health practitioners and policy makers in the United States (Tedstone & Tarrier, 2003).
    [Show full text]
  • Mental Health and Chronic Diseases CDC Fact Sheet
    Mental Health and Chronic Diseases Issue Brief No. 2 October 2012 Background Chronic diseases are non-communicable illnesses that are prolonged in duration, do not resolve spontaneously, and are rarely cured completely. They are the leading cause of death and disability in the United States. They cause 7 out of 10 deaths each year and are among the most preventable and treatable of all health problems (see figure below). Chronic diseases include illness such as heart disease, diabetes, cancer, and arthritis.1 Mental health disorders are medical conditions that disrupt a person's thinking, feeling, mood, ability to relate to others and daily functioning. They are medical conditions that often result in a reduced ability to cope with the routine daily activities such as going to work or raising a family. Just like chronic diseases, mental health disorders are treatable. Most people diagnosed with a serious mental health disorder can receive relief from their symptoms by following a treatment plan specifically designed for them by a trained psychologist or psychiatrist. Mental health disorders are not exclusive to those who exhibit a lack of personal strength, personality traits like being shy, or have a certain socioeconomic status. Mental health disorders include illnesses such as major depression, bipolar disorder, obsessive compulsive disorder, and post-traumatic stress disorder. One common finding is that people who suffer from a chronic disease are more likely to also suffer from depression.2 Scientists have yet to determine if having a chronic disease increases the prevalence of depression or depression increases the risk of obtaining a chronic disease.
    [Show full text]
  • UHS Adult Major Trauma Guidelines 2014
    Adult Major Trauma Guidelines University Hospital Southampton NHS Foundation Trust Version 1.1 Dr Andy Eynon Director of Major Trauma, Consultant in Neurosciences Intensive Care Dr Simon Hughes Deputy Director of Major Trauma, Consultant Anaesthetist Dr Elizabeth Shewry Locum Consultant Anaesthetist in Major Trauma Version 1 Dr Andy Eynon Dr Simon Hughes Dr Elizabeth ShewryVersion 1 1 UHS Adult Major Trauma Guidelines 2014 NOTE: These guidelines are regularly updated. Check the intranet for the latest version. DO NOT PRINT HARD COPIES Please note these Major Trauma Guidelines are for UHS Adult Major Trauma Patients. The Wessex Children’s Major Trauma Guidelines may be found at http://staffnet/TrustDocsMedia/DocsForAllStaff/Clinical/Childr ensMajorTraumaGuideline/Wessexchildrensmajortraumaguid eline.doc NOTE: If you are concerned about a patient under the age of 16 please contact SORT (02380 775502) who will give valuable clinical advice and assistance by phone to the Trauma Unit and coordinate any transfer required. http://www.sort.nhs.uk/home.aspx Please note current versions of individual University Hospital South- ampton Major Trauma guidelines can be found by following the link below. http://staffnet/TrustDocuments/Departmentanddivision- specificdocuments/Major-trauma-centre/Major-trauma-centre.aspx Version 1 Dr Andy Eynon Dr Simon Hughes Dr Elizabeth Shewry 2 UHS Adult Major Trauma Guidelines 2014 Contents Please ‘control + click’ on each ‘Section’ below to link to individual sections. Section_1: Preparation for Major Trauma Admissions
    [Show full text]
  • Mental Health Disorders by David Murphey, Ph.D., Megan Barry, B.A., and Brigitte Vaughn, M.S
    ADOLESCENT HEALTH HIGHLIGHT Publication # 2013-1 January 2013 Fast Facts Mental Health Disorders By David Murphey, Ph.D., Megan Barry, B.A., and Brigitte Vaughn, M.S. Mental disorders are diagnosable conditions characterized by changes in Mental disorders in adolescence are 1. thinking, mood, or behavior (or some combination of these) that can cause a common: An estimated one in five person to feel stressed out and impair his or her ability to function. These adolescents has a diagnosable disorders are common in adolescence. This Adolescent Health Highlight disorder.1 presents the warning signs of mental disorders; describes the types of mental disorders and their prevalence and trends; discusses the 2. Adolescence is the time when many consequences and risk of mental disorders; presents treatment options and mental disorders first arise. More barriers to accessing mental health care; and provides mental health than half of all mental disorders and resources. problems with substance abuse The definition and complexities of mental disorders (such as binge drinking and illegal drug use) begin by age 14.2 Medical science increasingly recognizes the vital link between a person’s physical health and his or her mental/emotional health. Mind and body are connected as one, each affected by the other, and both are influenced by a 3. The most prevalent mental disorder person’s genetic inheritance, environment, and experience. Just as the experienced among adolescents is 4 absence of disease does not adequately define physical health, mental depression, with more than one in health consists of more than the absence of mental disorders. Mental health four high school students found to is best seen as falling along a continuum, which fluctuates over time, and have at least mild symptoms of this across individuals, as well as within a single individual.3 condition.5 As defined in this Highlight, mental disorders are diagnosable conditions characterized by changes in thinking, mood, or behavior (or some 4.
    [Show full text]
  • SCI Facts and Figures at a Glance 2019.Pdf
    Spinal Cord Injury Facts and Figures at a Glance 2019 SCI Data Sheet This data sheet is a quick Incidence reference on demographics and the use of services by people Given the current U.S. population size of 328 million people, a recent estimate showed that the annual with spinal cord injury in the incidence of spinal cord injury (SCI) is approximately 54 cases per one million people in the United United States (U.S.). Much of the States, or about 17,730 new SCI cases each year. New SCI cases do not include those who die at the information reflects recent data location of the incident that caused the SCI. collected since 2015. Historical Data Source: Jain NB, Ayers GD, Peterson EN, et al. Traumatic spinal cord injury in the United States, information reflects data 1993-2012. JAMA. 2015;313(22):2236-2243. collected since the early 1970s. Prevalence The estimated number of people with SCI living in the United States is approximately 291,000 persons, with a range from 249,000 to 363,000 persons. The National Spinal Cord Injury Database is a prospective Data Source: Lasfargues JE, Custis D, Morrone F, Carswell J, Nguyen T. A model for estimating spinal longitudinal multicenter study cord injury prevalence in the United States. Paraplegia. 1995;33(2):62-68. that currently captures data from an estimated 6% of new Age at Injury SCI cases in the United States. The average age at injury has increased from 29 years during the 1970s to 43 years recently. The database has demographic and condition status data Gender through 2018 for 33,406 people About 78% of new SCI cases are male.
    [Show full text]
  • The ICD-10 Classification of Mental and Behavioural Disorders Diagnostic Criteria for Research
    The ICD-10 Classification of Mental and Behavioural Disorders Diagnostic criteria for research World Health Organization Geneva The World Health Organization is a specialized agency of the United Nations with primary responsibility for international health matters and public health. Through this organization, which was created in 1948, the health professions of some 180 countries exchange their knowledge and experience with the aim of making possible the attainment by all citizens of the world by the year 2000 of a level of health that will permit them to lead a socially and economically productive life. By means of direct technical cooperation with its Member States, and by stimulating such cooperation among them, WHO promotes the development of comprehensive health services, the prevention and control of diseases, the improvement of environmental conditions, the development of human resources for health, the coordination and development of biomedical and health services research, and the planning and implementation of health programmes. These broad fields of endeavour encompass a wide variety of activities, such as developing systems of primary health care that reach the whole population of Member countries; promoting the health of mothers and children; combating malnutrition; controlling malaria and other communicable diseases including tuberculosis and leprosy; coordinating the global strategy for the prevention and control of AIDS; having achieved the eradication of smallpox, promoting mass immunization against a number of other
    [Show full text]