Psychological harm means Iraqis suffer 'double blow'

The people of Iraq are facing a "double blow" in an epidemic of psychological damage being caused by the continuing violence, it was claimed in the British Medical Journal yesterday.

The sheer numbers killed since the invasion is a pointer to the huge proportion of people who would have been exposed to severe violence, Dr Michael E Reschen wrote.

Previous studies have shown that the risk of developing post-traumatic stress disorder following a traumatic event ranged from 7.5 per cent to 72 per cent, with the risk highest in those exposed to sustained combat trauma.

Dr Reschen, of the John Radcliffe Hospital in Oxford, writes in the BMJ: "With over 500,000 violent deaths there will no doubt have been many more people exposed to grave violence.

"It therefore seems likely that the nation of Iraq may suffer a double blow, firstly by losing a sizeable proportion of its population - and the study shows that 15-45 year olds are most commonly affected - and secondly by the serious consequence of people with post-traumatic stress disorder. This may also be compounded by cultural barriers that prevent people from seeking psychological help."

Dr Reschen pointed out that while the coalition forces' medical facilities have been used to treat injured civilians in Iraq, nothing similar has been done for those suffering mental illness.

"We must learn the lessons of history and expedite the psychiatric help for Iraqi civilians," he added.

Dr Reschen is the latest medical figure to point out the psychological cost being incurred in Iraq. Dr Majid al-Yassiri, the chairman of the London-based Centre for Psychosocial Services in Iraq, has said: "Children in particular are showing behavioural problems and depression at a higher rate than one would expect in a population this size - three times as high. The impact of torture, war, continuous trauma and bereavement will take its toll on families."

Dr Yassiri said many Iraqis were reluctant to admit to mental health problems. "There is a stigma. Women in particular are less likely to seek help unless they become psychotic or suicidal, because of the fear of being seen as mad and not being able to marry," he said.

Iraq's largest psychological hospital, which had more than 1,500 beds, was destroyed in the war. Another hospital has a psychological unit but it has only two doctors.