Quickly giving morphine to wounded troops cuts in half the chance they will develop post-traumatic stress disorder, according to a provocative study that suggests a new strategy for preventing the psychological fallout of war.
Researchers at the U.S. Naval Health Research Center led the study of about 700 troops injured in Iraq from 2004 through 2006.
"It was surprising how strong the effect of the morphine was," said study leader Troy Lisa Holbrook, an epidemiologist at the naval center. The findings were published in Thursday's New England Journal of Medicine.
Whether the Pentagon will adopt the practice on the battlefield remains to be seen. Dr. Jack Smith, acting deputy assistant secretary of defense for clinical and program policy, said in an e-mail that the "very interesting findings" are "likely to stimulate further research."
About 53,000 troops returning from Iraq and Afghanistan have been treated for PTSD, a disorder in which someone who has endured a traumatic event keeps re-experiencing it and the fear it caused. Patients often have trouble with work, relationships, substance abuse and physical ailments.
Researchers have been testing ways to treat it, and the new study looked at whether fast and strong pain relief can help prevent it.
It was unclear whether it was the fast pain treatment or something specific to morphine that made the difference.
A second study in the journal found that Army wives were more likely to develop depression or sleep problems the longer, or the more times, their spouses were sent to Iraq or Afghanistan.
That study, by researchers at the University of North Carolina and elsewhere, examined medical records for outpatient care of about 250,000 wives of active-duty soldiers from 2003 through 2006.
Compared with wives whose husbands stayed home, those whose husbands were deployed for up to 11 months were 18 percent more likely to be diagnosed with depression and at least 20 percent more likely to be diagnosed with sleep disorders, anxiety and acute stress.
For wives whose husbands were deployed for more than 11 months, problems were even more common: They were at least 24 percent more likely to be diagnosed with depression or anxiety, and about 40 percent more likely to be diagnosed with acute stress or sleep problems.
The researchers didn't have data showing whether husbands were deployed or at home when the wives were being treated for mental health problems.
That meant the scientists couldn't conclude whether those problems were caused by worries about the spouse's safety and the difficulties of being a single parent, or by stress caused by the returning spouse's psychological problems or other behavior changes.
"I suspect that if you look at the Reserve and National Guard wives, the toll might be even worse," because they have less social support than families living in a military community, Rothbaum said.
She said the effects of deployment on children also need to be studied so the military can figure out how to provide more help to families.
On the Net: http://www.nejm.org