The Journal of Neuropsychiatry
& Clinical Neurosciences

Recent research has demonstrated that veterans with chronic combat-related posttraumatic stress disorder (PTSD) have a twofold increased risk of developing dementia. This review of current literature details neuroanatomical differences between veterans with PTSD and control subjects, some of whom have also had combat experience. The most common and consistent difference was in size of the hippocampus, which was found to be smaller in PTSD patients. There is a hypothesis that smaller hippocampal area is associated with greater risk for dementia; however, an alternate hypothesis is that a smaller hippocampus predisposes to PTSD.

The authors investigated factors relevant to treatment retention and initial adherence in patients with psychogenic non-epileptic seizures. The factors studies were 1) treatment modality, that is, whether psychotherapy and neuropsychiatric management were provided in the same institution or at a different location, and 2) subject characteristics. Modes of treatment provided at the same location yielded greater compliance than “divided intervention,” where subjects attended different settings for each approach. Subjects with cognitive complaints and those on anti-epileptic drugs showed lower compliance rates, whereas married subjects showed greater compliance.

The authors explain and detail the effects of the kinetic energy of blast shock waves on the CNS, specifically, the volumetric blood surge through the brain and large and small blood vessels and its neuropsychiatric effects. In addition to the physical and/or cognitive effects of blast injury, this pressure effect may be associated with posttraumatic stress disorder and reactive depression.