There's no question that plenty of soldiers from the wars in Iraq and Afghanistan are afflicted with post-traumatic stress disorder (PTSD). But exactly how many soldiers? That's a question that even top medical experts, not to mention military officials, still can't quite answer.
Now a new consortium, manned by some of the nation’s top scientists where PTSD is concerned, is hoping to develop an objective means of diagnosing the condition. In other words, the group hopes that the illness can — one day soon — be diagnosed using medical techniques like blood tests or brain scans, rather than self-reported symptoms.
“If you think about it, most PTSD assessment is done by self-reporting,” Dr. Roger Pitman, one of the consortium leaders and himself the director of the PTSD Research Lab at the Massachusetts General Hospital, tells me. “But we’ve found that patients can, of course, be imperfect reporters of their own states.”
Relying on self-reported symptoms to make a diagnosis is, even for the best clinicians, difficult enough. Among military populations, the diagnosis of PTSD has been hampered, quite publicly, by additional challenges. Soldiers who avoid seeking help and therefore go undiagnosed, as well as concerns over just how accurate the military’s diagnosis process actually is, are but two examples.
“Just as our behavioral health professionals are committed to providing the best care, we, too, must ensure that our processes and procedures are thorough, fair and conducted in accordance with appropriate, consistent medical standards,” Army Secretary John McHugh said in a recent statement that announced plans for a widespread review of Army policies on PTSD diagnoses.
This new consortium, which was spearheaded by Draper Laboratories (a non-profit spin-off of MIT), could make those medical standards much more consistent. Researchers, including top-notch experts at Harvard, Boston University, Mount Sinai Hospital and several VA Medical Centers, plan to track more than 2,000 people (military and civilian) who are exposed to traumatic events — most likely car accidents — from across the country.
The intent is to measure, both shortly after the experience and in later years, several different biomarkers — including hormones, genetic data and neurological factors — to parse out a select group of “markers” that can accurately diagnose PTSD. From there, the group hopes to come up with a systematic diagnostic plan, say a combination of blood test and fMRI scan, that can replace (or at least markedly enhance) self-reporting.
“Nobody has embarked on a study of this scope, to turn subjective strategies of diagnosis into objective ones,” Dr. Pitman says. Indeed, although researchers at several institutions have found biomarkers that suggest either vulnerability to PTSD or an outright diagnosis, there’s yet to be a widespread collaboration that looks at a host biomarkers in a single study population.
The study, which will cost an estimated $50 million, according to Dr. Len Polizzotto, Draper Lab’s vice-president, is in the final planning stages. That said, the consortium still needs to secure funding — which they hope to do, in part, with military research dollars. And while the Pentagon is already funding plenty of research into PTSD, including pharmaceuticals that target fear response and tests to pin down PTSD biomarkers, they’ve yet to embark on a project of this scope.
“To have an impact on such an important issue, you need to expand the efforts,” Dr. Polizzotto says. “We have the best of the best in the country, and they’re ready to do this.”
By Katie Drummond, Contributor
September 4, 2012