Veterans Affairs committee  Mr. André, this problem is not unique to post-traumatic stress. It affects mental health as a whole. There is still a stigma surrounding it, and there is still a lack of information. I must also say that my psychiatric colleagues do not always take the time to explain to families what it involves, to tell them about what we know about the illness and why a given treatment is administered.

Veterans Affairs committee  Yes, but it's the same thing. It takes time to explain these things.

Veterans Affairs committee  Removing the stigma would already be a huge step. It would involve explaining that it is not a weakness or an inadequate behaviour coming through, but an actual biological phenomenon.

Veterans Affairs committee  We already have medications. Sometimes they aren't as effective as we'd like them to be, but they exist already.

Veterans Affairs committee  But it's exactly what we've been starting to discuss with our colleagues at Veterans Affairs—

Veterans Affairs committee  No, absolutely. Quite frankly, there are some results we already have that need to be implemented in a more systematic fashion and evaluated. One thing is implementing them, but evaluating the long-term effect of treatments, comparing them, doing true clinical trials, and ensuring that we truly exert the effective—

Veterans Affairs committee  Thank you.

Veterans Affairs committee  Absolutely, and it is always difficult to assess. We are clearly talking about an average. It seems that about a quarter of people are much more likely to react over an extended period of time after being exposed to intense stress, as we are seeing in this case. But, in others, the system restores itself normally.

Veterans Affairs committee  Unlike economists, I don't like making predictions. But, it is clear to me that we need to continue subsidizing research that focuses on making early diagnoses, so we can prevent rather than cure. I think that, once the stress is established and these people have entered a vicious circle, it is clear that there are considerable neuronal and hormonal malfunctions.

Veterans Affairs committee  My understanding, from what I know of the literature, is that it's still a big syndrome, but there could be a narrowing down that has occurred that I'm not aware of. You have to remember that I'm funding research; I'm not a researcher working in the field.

Veterans Affairs committee  It's the same thing. But it's because what you're describing is an extinguishing mechanism that works. That's the normal mechanism. First of all, I find it very interesting--it's not fun, but it's very interesting--that such a high proportion of the population develops post-traumatic stress disorder.

Veterans Affairs committee  Actually, you know, it's very interesting, because you're putting your finger right on the tender spot. We have a dual mandate at CIHR: to create knowledge, and to ensure that this knowledge, as I read earlier, is translated into better health outcomes and a better health care system.

Veterans Affairs committee  It's a difficult question and, again, I'm not an expert. Yes, we are actually funding research in that area. What you're describing is typical of post-traumatic stress disorder. Again, you have to understand it as the brain circuits that are involved in fear. These brain circuits also involve the hormonal axis that will release noradrenalin, adrenalin, and corticosterone in the bloodstream when you face anxiety and any stressful situation.

Veterans Affairs committee  It's always very difficult to.... Actually, they could exist, but I'm not aware of longitudinal studies that are looking at before and after, but there's a lot of comparison between the normal population and the population that has been exposed to stress, and comparisons between people who have been exposed to combat stress versus other types of stress.

Veterans Affairs committee  But the syndrome is pretty well defined, though.