and Mr John C. Wright
Sir: Clinical experience and research do not bear out Professor Wade's assertion (Letters, 31 March) that "the natural tendency is for full recovery [of post traumatic stress disorder] in days or weeks ..." The reality for many people is that they will experience distressing and disabling symptoms for many years, which may worsen over time. The argument that compensation delays recovery is similar to the once fashionable, but now thoroughly discredited notion that post-concussive symptoms following head injury do not resolve until litigation is settled.
His claim that "most people who suffered flood, famine, shipwreck or war, if they survived, were grateful and set about rebuilding their life" appears to be unduly optimistic in the light of current knowledge of the psychological aftermath of disasters. Following the Buffalo Creek flood, more than 30 per cent of those involved continued to exhibit debilitating psychiatric symptoms four to five years later; 71 per cent of Australians shipwrecked in 1973 were found to be suffering from psychiatric disorders one to two years after the event; 43 per cent of American soldiers exposed to the Vietnam war zone were identified as having high levels of psychiatric disorders more than 10 years later.
The effects on children should not be forgotten: 70 per cent of children living in Kuwait at the time of the Gulf crisis developed post-traumatic stress reactions. In view of the raised suicide risk associated with this diagnosis, the utmost caution is called for, as people may appear to have made a good social recovery while remaining severely traumatised.
JOHN C. WRIGHT
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