Invisible wounds of war: psychological and cognitive injuries, their consequences, and services to assist recovery

The wars in Afghanistan and Iraq : an overview -- Prevalence of PTSD, depression, and TBI among returning servicemembers -- Survey of individuals previously deployed for OEF/OIF -- Predicting the immediate and long-term consequences of post-traumatic stress disorder, depression, and traumatic brain injury in veterans of Operation Enduring Freedom and Operation Iraqi Freedom -- The cost of post-deployment mental health and cognitive conditions -- Systems of care : challenges and opportunities to improve access to high-quality care -- Treating the invisible wounds of war : conclusions and recommendations

Since October 2001, approximately 1.64 million U.S. troops have been deployed for Operations Enduring Freedom and Iraqi Freedom (OEF/OIF) in Afghanistan and Iraq. Early evidence suggests that the psychological toll of these deployments -- many involving prolonged exposure to combat-related stress over multiple rotations ---

may be disproportionately high compared with the physical injuries of combat. In the face of mounting public concern over post-deployment health care issues confronting OEF/OIF veterans, several task forces, independent review groups, and a Presidential Commission have been convened to examine the care of the war wounded and make recommendations. Concerns have been most recently centered on two combat-related injuries in particular: post-traumatic stress disorder and traumatic brain injury. With the increasing incidence of suicide and suicide attempts among returning veterans, concern about depression is also on the rise. The study discussed in this monograph focuses on post-traumatic stress disorder, major depression, and traumatic brain injury, not only because of current high-level policy interest but also because, unlike the physical wounds of war, these conditions are often invisible to the eye, remaining invisible to other servicemembers, family members, and society in general.-