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At least 19 recordsLinked to original sources

Assessment of Viet Nam veterans for posttraumatic stress disorder in Veterans Administration disability claims.

Since the Veterans Administration (VA) authorized compensation and other benefits for posttraumatic stress disorder, delayed type, in October 1980, the agency has received an increasingly large number of claims--mainly from Viet Nam veterans--for this disorder. An unprecedented challenge of the adequacy of psychiatric disability evaluation in the VA has thus been created. The authors describe efforts in one large program to meet this challenge and review 12 problems in the diagnostic process. Cooperation of all parties in claims transactions, thorough claimant assessment, reliance on DSM-III criteria and methods and consultation with examiners are essential principles for this work.

Adult↗

Chronic morbidity of former prisoners of war and other Australian veterans.

OBJECTIVE: This report is the first summary article from a review of studies on long-term morbidity associated with war service or internment, commissioned by the Sir Edward Dunlop Medical Research Foundation. DATA SOURCES: The Medlars database, from 1966 to the present, under the terms military personnel, veterans, veterans' disability claims, combat disorders and prisoners (matched against war); databases of the Department of Veterans' Affairs (Victoria) and the Central Library, Commonwealth Department of Defence, using the term "prisoner of war"; and the microfiche listings of the Department of Veterans' Affairs, under "prisoner of war" and "repatriation". Only studies in English or French were reviewed, reaching a total of 172. STUDY SELECTION: Forty-eight studies are considered in the present summary, presenting the most significant evidence about long-term morbidity attributable to war-time experiences. Studies concerning Australian veterans are emphasised. DATA EXTRACTION: Studies considered valid were summarised for an annotated bibliography, but only reports of major public health significance are reviewed here. DATA SYNTHESIS: The review confirms that strongyloidiasis, peptic ulcer, anxiety states, depression and hepatitis B are more prevalent in former prisoners of war than in relevant comparison groups. We have not identified further diagnoses that should be attributed specifically to war-time exposures. Attribution of long-term neurological and musculoskeletal disorders to war-time exposures remains uncertain. CONCLUSIONS: Former prisoners of war and veterans constitute a population of survivors highly selected by the rigours of war and imprisonment. Occurrence of the five conditions listed above may be reasonably attributed to war-time exposure. We recommend further research on ageing (including neurological, visual, hearing and musculoskeletal disability), family disruption and rehabilitation strategies in these groups.

Australia↗

Mortality of former prisoners of war and other Australian veterans.

OBJECTIVE: This second summary article from an epidemiological review of the health of former prisoners of war (POWs) and other Australian veterans, commissioned by the Sir Edward Dunlop Medical Research Foundation, reports on studies of mortality. DATA SOURCES: The MEDLARS database, from 1966 to the present, under the terms military personnel, veterans, veterans' disability claims, combat disorders and prisoners (matched against war); databases of the Department of Veterans' Affairs (Victoria) and the Central Library, Commonwealth Department of Defense, under the term "prisoner of war"; and the microfiche listings of the Department of Veterans' Affairs, under "prisoner of war" and "repatriation". Only studies in English or French were reviewed, reaching a total of 172. STUDY SELECTION: Four studies in this paper constitute the main evidence about postwar mortality in Australians who were POWs of World War II or Vietnam veterans. Other mortality studies are cited in the complete literature review published elsewhere. DATA EXTRACTION: Only the data with an epidemiological basis are considered here. DATA SYNTHESIS: All-cause mortality rates were no greater in former POWs or Vietnam veterans than in the general Australian male population. There was, however, evidence of increased mortality among former POWs compared with other non-POW veterans, and among Vietnam veterans in one particular corps compared with veterans of the same era who served in Australia. CONCLUSIONS: Elevated early postwar mortality of young former POWs implicates diseases with short latent periods (including psychiatric disorders). This is consistent with the greater health risks of this group of survivors that were identified in the earlier review of morbidity. Mortality among former POWs and other veterans requires continued surveillance because a "healthy worker effect" (or exclusion of unfit persons from the armed forces) may partly conceal increased morbidity or mortality that should be attributed to war service.

Adult↗

Symptoms in veterans considering compensation claims.

The symptomatology of 56 male veterans considering compensation claims was compared to the symptomatology seen in 163 veterans not considering such claims. Antisocial behaviors, somatic/neurotic complaints, and persecutory ideas were all positively correlated with consideration of a claim. Although the symptom profile is consistent with diagnosis of antisocial personality, a correlation with this diagnosis was not established. Nonetheless, the clinical profile does suggest a link between noncompensable disorders and consideration of a claim. The implications of this finding for military and Veterans Administration psychiatry are discussed.

Adult↗

Do Vietnam veterans suffer from toxic neurasthenia?

This paper evaluates the claim that Vietnam veterans with psychiatric disorders are suffering from toxic neurasthenia--a neurasthenic syndrome caused by exposure to pesticides while serving in Vietnam.

2,4,5-Trichlorophenoxyacetic Acid↗

Psychodynamic and social development of neurotic patients applying for disability compensation: a catamnestic study.

Neurotic illnesses in which the desire for compensation or pensioning complicates the picture must not always take an unfavorable course. Prognostic criteria allowing definitive projections for individual cases are not available. The award or denial of compensation--in a group comparison--has no influence on the neurotic symptomatology. There are no differences in the psychodynamic and social histories of those subjects who apply for a pension because of the inability to work and those who claim compensation following an external trauma. In one-fourth of the subjects who were examined in connection with accidental or war injury, conspicuous personality characteristics could be demonstrated for the time preceding the incident. Satisfactory therapeutic possibilities for the group of neurotic applicants for disability compensation or pensions are not yet available.

Disability Evaluation↗

Optimum radiographic examination for consideration of compensation awards: II. Cervical and lumbar spines.

In a large Veterans Administration (VA) hospital, a prospective study was undertaken to determine the optimum number of radiographic projections needed to assess applicants for VA compensation for cervical and lumbar spine disease or injury claimed to be service-related. Results show that the final radiographic assessment could be made in 100% (245) of cervical spine examinations using two views (anteroposterior and lateral) and in 99.3% (699/704) of lumbar spine examinations using two views (anteroposterior and a single well centered lateral). Extrapolating these results to data on compensation examinations performed in the entire VA system (fiscal year 1978), it was concluded that limiting the radiographic examinations of the cervical and lumbar spines to these views would eliminate 193,000 radiographs in the evaluation of 100,000 applicants and yield an annual savings of about $1,000,000.

Accidents, Occupational↗

Optimum radiographic examination for consideration of compensation awards: III. Knee, hand and foot.

In a large Veterans Administration (VA) hospital, a prospective study was undertaken to determine the optimum number of radiographic projections needed to assess applicants for VA compensation for knee, hand, and foot diseases or injury claimed to be service-related. Results show that the final radiographic assessment could be made in all 535 (100%) of the knee examinations using two views (anteroposterior and lateral), all 181 (100%) of the hand examinations using one view (anteroposterior), and all 223 (100%) of the foot examinations using two views (anteroposterior and lateral). Extrapolating these results to data on compensation examinations performed in the entire VA system (fiscal year 1978), it was concluded that limiting the radiographic examinations of the knee, hand, and foot to these views would eliminate 91,000 radiographs in the evaluation of 119,000 applicants and yield an annual savings of about $500,000.

Accidents, Occupational↗

Optimum radiographic examination for consideration of compensation awards: I. General methodology and application to chest examination.

A major goal of the radiologist is to devise methods to decrease health care costs and radiation exposure without sacrificing diagnostic accuracy. In a large Veterans Administration (VA) hospital, a prospective study was undertaken to determine the optimum number of radiographic projections needed to assess applicants for VA compensation for chest disease or injury claimed to be service-related. Three separate readings of every chest radiographic assessment could have been made from a single posteroanterior view. In eight cases, granulomas or mild hyperexpansion of the lungs were only appreciated using the lateral projection, but these findings were not clinically significant and did not affect decisions as to whether compensation sould be awarded. The only potentially serious lesion missed (a possible pulmonary nodule) using the posteroanterior view alone was also missed using the lateral and only suggested by the oblique views. Extrapolating these results to data on compensation examinations performed in the entire VA system (fiscal year 1978), it was concluded that limiting the radiographic examination of the chest to a single posteroanterior view would eliminate 150,000 radiographs in the evaluation of 190,000 applicants and yield an annual savings of almost $900,000.

Accidents, Occupational↗

Compensation seeking status and psychometric assessment of combat veterans seeking treatment for PTSD.

Examined differences between compensation seeking (CS) veterans and noncompensation seeking (NCS) veterans on the Minnesota Multiphasic Personality Inventory-2 (MMPI-2) and other psychological measures in 142 combat veterans evaluated for posttraumatic stress disorder (PTSD) at an outpatient Veterans Affairs (VA) hospital PTSD clinic. Patients were grouped on the basis of their compensation seeking status, with 69% classified as CS for PTSD. The CS veterans achieved significantly more pathological scores across a wide range of psychological inventories and MMPI-2 validity indices, although they did not differ in frequency of PTSD diagnoses from NCS veterans. Implications of these findings are discussed, and clinicians are advised to be aware of the compensation seeking status of combat-veterans being evaluated for PTSD.

Adult↗

[About insurance medical evaluation of psychoreactive disturbances (author's transl)].

Results arising from injuries within the valid field of the statutory Accident Insurance and of the Federal Law Governing Pensions and Grants can only be recognized as such and give rise to financial compensations if bodily or psychic damages within the legally protected Risk Area are made "probable", and if a connexion between these injuries and the unbiased finding of the actual health disorders prove to be "substantial". The assessment of the damage must bear in mind the individual conditions of the victims. Symptomatology, differential diagnosis and medical insurance estimation of the "neurosis in the true sense", of the personality alteration brought about by selfexperienced hardships (concentration camp neurosis) and the psychogenic breeding of symptoms with a final view to having an ailment recognized, are discussed with a special bearing on the phenomenons which cause the will to express itself.

Concentration Camps↗

The effects of compensation on psychiatric disability.

Psychiatrically impaired veterans who were receiving 100%, partial or no compensation for their psychiatric disabilities were compared on type and level of psychopathology, self-esteem, locus of control and treatment utilization. All groups were highly elevated on measures on measures of psychopathology. There were no differences between groups on psychopathology measures, except that the 100% group scored significantly higher than the uncompensated group on hostility. Differences in locus of control were not found. On 3 of 10 subscales, partially compensated patients reported higher levels of self-esteem than patients in one or both of the other groups. Uncompensated patients required the most hospitalization. Those who were receiving 100% disability compensation required less hospitalization and the number of days they spent in the hospital was significantly reduced following attainment of full compensation.

Adult↗

The pathology of primary blast overpressure injury.

Primary blast injury occurs in civilian and military detonations and from the firing of weapon systems. The pathology of primary blast injury has been reported for the last 70 years and has primarily been limited to descriptions of gross pathology and histology. Commonly accepted tenets have not been confirmed as blast overpressure experiments in enclosures and with multiple detonations have been conducted. Organ systems other than the ear and the lung are playing a greater role in injury definition and research importance. This paper is an overview and update of the current understanding of the pathology of primary blast injury.

Abdominal Injuries↗