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(PSYCHIATRIC TIMES) - Chronic posttraumatic stress disorder (PTSD) may occur secondary to combat, terrorism, civilian assaults including physical and sexual abuse, or other traumatic experiences. This month’s special report includes a series of articles that address contemporaneous topics of interest to practicing clinicians. The focus in this series is the link between PTSD and sleep disturbances, traumatic brain injury, dissociation, and the prevalence of violence among minority populations. In many respects we live in troubled times and a better understanding of these issues is vital to the initial approach to patients. It was a pleasure reading these articles, and I hope that you will find them useful as well.

Neylan provides a synopsis of sleep disturbances associated with PTSD. Insomnia and sleep disturbances such as nightmares occur frequently in patients with PTSD. Disturbed sleep is associated with a wide range of adverse conditions, including fatigue, cognitive impairment, mood disturbance, and reduced quality of life, as well as increased frequency of accidents, aggression, and use of alcohol. The article also provides a concise overview of psychotherapeutic and pharmacological treatment strategies.


The assessment of traumatic brain injury (TBI) in the context of PTSD is reviewed by Granacher. This is a topic of critical interest to clinicians who treat veterans of the Afghanistan and Iraq conflicts, as well as other populations. The authors address the epidemiology of this comorbidity, potential mechanisms, and other neuropsychiatric syndromes associated with TBI, and they review practical aspects for the assessment of PTSD associated with TBI. They suggest 3 approaches to treatment—including psychopharmacological therapy for cognitive deficits associated with TBI and pharmacotherapy and psychotherapy for PTSD symptoms.

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