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deputy director, W. Montague Cobb/NMA Health Institute.
Retired from the U.S. Navy after 25 years of service, Dr.
Lewis also serves as adjunct associate professor of family
medicine and community health at Robert Wood Johnson
Medical School.
ith more wartime veterans entering their prac-
tices, today's health care providers will need to
gain a greater recognition of the signs of post-
traumatic stress disorder and other physical and
mental health conditions--a major focus of Robert Wood
Johnson Medical School's training program.
The lifetime prevalence of PTSD in the general popula-
tion is 810 percent; for veterans who have served in a war
zone, the lifetime prevalence of PTSD may be as much as
three times higher, says Anthony M. Tobia, MD, associate
professor of psychiatry, one of the presenters during the
program. In addition, traumatic brain injury is becoming
more of a problem, Dr. Tobia says, affecting about one-fifth
of those returning from Iraq. Some 44 percent of returnees
from Iraq who reported TBI with loss of consciousness and
post-concussive symptoms three to four months after rede-
ployment also exhibit symptoms of PTSD, he notes.
PTSD is widely believed to be underreported and under-
diagnosed, says Dr. Lewis.
For service members who are veterans of the war in
Afghanistan or Iraq, or both, 75 percent were in situations
where death was a real and potentially imminent threat.
More than 60 percent knew someone who was injured or
killed. These experiences are compounded by what Dr.
Lewis calls "moral injuries": "There is an inner sense of
who you are, what helps you distinguish between right and
wrong. It could be a result of your family values, religion,
spirituality. While in the theater, you'll often be doing
things that are in direct conflict with that. These moral
injuries are some of the most impactful."
To get a better understanding of the issues that veterans
with PTSD face, first-year students at Robert Wood
Johnson Medical School met this year with veterans who
have PTSD, TBI, or both during a half day devoted to train-
ing about different disabilities; while there, the students
had the opportunity to interact with the veterans and learn
more about their experiences.
Robert Wood Johnson