Extract
To The Editor:Posttraumatic stress disorder is a serious psychological condition that has
received increasing attention over the past decade. Starr et al. should be
commended for their attempt, in their article "Symptoms of Posttraumatic
Stress Disorder After Orthopaedic Trauma" (2004;86:1115-21), to alert
orthopaedic surgeons to the fact that psychological consequences of a severe
orthopaedic injury are possible and important. Nonetheless, the percentage of
respondents who "met the criteria" for posttraumatic stress
disorder (as measured with the Revised Civilian Mississippi Scale for
Posttraumatic Stress Disorder) was startlingly high. Because the presence of a
serious psychiatric disorder in more than one-half of a traumatized sample is
exceedingly rare, it led me to examine the methods and analytic strategy used
in this report. There are a number of issues that deserve mention.