Letter: Post-traumatic stress: dubious diagnosis, bad law

From Professor O. L. Wade

Sir: Although the Law Commission's proposals about compensation for post- traumatic stress disorder ("Families who see death on TV `deserve damages' ", 29 March) are no doubt based on a humane desire to help people who suffer, let me advise the utmost caution. The good intentions may well lead to increased suffering, as has been observed by many of us who have had experiences of compensation for industrial injuries.

Post-traumatic stress is a very doubtful diagnosis. Over the centuries, most people who suffered flood, famine, shipwreck or war, if they survived, were grateful and set about rebuilding their life. In the Second World War, under battle stress and dive-bombing, men might have slept badly and relived battle experiences, but after a few days' sedation and 28 days' full leave, most were back with their unit. The natural tendency is for full recovery in days or weeks - not months or years.

Promulgation of the diagnosis of post-traumatic stress by councillors or lawyers, especially if there is evidence that the community is prepared to pay compensation, will delay natural recovery. Money will be paraded as the main issue and recovery will not be mentioned. Memories and misery will meanwhile persist.

Indeed, recovery of the unfortunate patient is likely to be delayed for a prolonged period, for it is going to be difficult for doctors and lawyers to apportion the contribution of a specific traumatic event to the causes of a mental illness, for which usually there will be many other contributing factors of personality and past history, and there will be much argument.

Yours sincerely,

O. L. WADE

Stratford-upon-Avon,

Warwickshire

29 March