This Week in JAMA FREE

A JAMA THEME ISSUE

Edited by Thomas B. Cole, MD, MPH, and Annette Flanagin, RN, MA

Screening for intimate partner violence is endorsed by many health organizations; however, evidence that screening is associated with health benefits is lacking. In a randomized trial that involved 2708 women at 10 primary care clinics, Klevens and colleagues assessed quality of life in 2 groups: women who completed computerized screening for partner violence and, if screening was positive, received a partner violence resource list, and women who were provided the resource list alone. At 1-year follow-up, the authors found that among women receiving care in primary care clinics, providing a partner violence resource list with or without screening did not result in improved quality of life. In an editorial, Wathen and MacMillan discuss a case-finding approach to identify women exposed to partner violence.

Whether cognitive-behavioral, exposure-based therapy for posttraumatic stress disorder (PTSD) is appropriate for patients with co-occurring substance dependence is not clear. Mills and colleagues randomly assigned 103 individuals who met standard diagnostic criteria for both disorders to receive either an integrated treatment program for PTSD and substance dependence (plus usual treatment for substance use) or usual treatment for substance dependence alone. The authors found that the integrated treatment program resulted in greater improvement in PTSD symptom severity without an increase in severity of substance dependence. In an editorial, Najavits discusses PTSD treatment adaptations for special populations.

Posttraumatic stress disorder (PTSD) may be associated with intimate relationship problems, which can affect PTSD treatment outcomes. In a randomized trial involving 40 couples in which 1 partner in each couple met criteria for PTSD, Monson and colleagues found that cognitive-behavioral conjoint therapy for PTSD—a manualized couple therapy to simultaneously treat PTSD symptoms and enhance relationship satisfaction—was associated with decreased PTSD symptom severity and increased relationship satisfaction compared with a wait-list condition.

Two research letters in this issue address health consequences of the March 2011 meltdown at the Fukushima Daiichi nuclear power plant. Shigemura and colleagues evaluated psychological status 2 to 3 months after the incident in a study involving 1495 plant workers. Tsubokura and colleagues assessed internal radiation exposure in a cohort of 9498 residents of Minamisoma, Japan, located 23 km north of the disaster site.

Three days after being struck in the eye with a plastic pole, a patient reported pain, vision loss, and photophobia. Examination revealed a corneal defect and foreign body. The patient has a history of laser in situ keratomileusis (LASIK) procedure. What would you do next?

Government forces in Bahrain continue to abuse both protesters seeking medical care and their clinicians.

Preventing suicide in military personnel

Health of refugees and the displaced

Catastrophic disaster response

Sexual violence as a weapon of war

“[P]erhaps the richness our colleagues are missing most is in stepping back and wondering at the marvel that is the interaction between age-related disease and the complexities of later life.” From “To Live (and Die) as an Original.”

Evolving quality of the evidence of health effects of violence and human rights abuses

Dr Cole summarizes and comments on this week's issue. Go to http://jama.ama-assn.org/misc/audiocommentary.dtl.

For your patients: Information about PTSD.