Evidence from: SJ Turnbull et al. Brain Injury. Sept (2001) Vol. 15 #9 p 775. PTSD is defined in part by the presence of intrusive memories of the traumatic event. It might be supposed that amnesia would lessen the impact. This was a small study designed to explore this self-evident truth. In fact it was found that groups of people with extensive amnesia or, no traumatic memories of the index event, have higher levels of psychological distress than do those with traumatic memories. Comment Amnesia does not appear to protect against adverse psychological consequences of trauma. But does protect against intrusive memories! Diagnosable harm is required for compensation purposes. It would seem PTSD should not be cited in cases of amnesia, other diagnoses should apply.   Evidence from: E Doig et al. Brain Injury. Sept (2001) Vol. 15 #9 p 747 Withdrawal from society/community following traumatic brain injury is a sign of loss of quality of life and may be considered when assessing damag

Evidence from: MB Glenn et al. Brain Injury. Sept (2001) Vol. 15 #9 P 811. A study of out patients with traumatic brain injury. At issue is the prevalence of depression. 41 outpatients were tested using the Beck Depression Inventory (BDI) at one year since the injury event. The BDI register someone as mildly depressed if they have a score of 13 or over. Moderate or severe depression corresponds to a score of 19 or more. 59% were >13 = depressed 34% were >19 = moderate or severe depression. Depression is a function of age, female gender, a negative view of the injury event, mild TBI and use of antidepressants. Comment At first this appears to indicate a high prevalence of clinical depression in TBI cases. However, his is an unusual group, most mild TBI cases don’t keep coming for outpatient work at one year, yet many of the cases here were mild TBI. The BDI measures severity and is not usually used for diagnosis. Alternate methods should have been applied to the diagnosis, before

Evidence from: K Turjanmaa. Allergy. September (2001) Vol. 56 # 9 p 810. An editorial on the subject of latex allergy. Allergy to natural rubber latex (NRL) has been known for over 20 years. While there remains no universal consensus on how to diagnose latex allergy- guidelines have been issued by the European Academy of Allergology and Clinical Immunology (EAACI) Allergy (1993) Vol. 48 supplement 14:57-62. Skin prick tests are believed by the author to be the most reliable, but allergen assays are non-standard. That is, the materials applied to the skin to test for allergy differ in allergen composition and concentration. EAACI are working on a revised guideline, now is the time to influence it. Comment Insurers may wish to consider becoming involved in the development of a standard for diagnosis. A widely accepted standard would reduce uncertainty. In fact latex contains a number of allergens, some of which are shared by a wide range of plants and other organisms. A diagnosis of late