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To the Editor: In their study of neuropsychological outcomes of Army personnel after deployment to the Iraq war, Dr Vasterling and colleagues¹ describe compromised attention span and memory, increased confusion, and tension. These symptoms can also be associated with grieving.² The authors did not report on the soldiers' exposure and grief reaction to death as an associated factor. Sudden and unexpected death has been associated with persistent grief reactions.³ The research literature is sparse with regard to neuropsychological symptoms and grieving among soldiers, and further studies should examine this relationship.

Financial Disclosures: None reported.

Patricia Boiko, MD, MPH
winning_pictures@yahoo.com
G. H. Factoria Medical Center
Seattle, Wash

1. Vasterling JJ, Proctor SP, Amoroso P, Kane R, Heeren T, White RF. Neuropsychological outcomes of army personnel following deployment to the Iraq war. JAMA. 2006;296:519-529. FREE FULL TEXT 2. Xavier FM, Ferraz MP, Trentini CM, Freitas NK, Moriguchi EH. Bereavement-related cognitive impairment in an oldest-old community-dwelling Brazilian sample. J Clin Exp Neuropsychol. 2002;24:294-301. ISI | PUBMED 3. Nader K, Pynoos R, Fairbanks L, Frederick C. Children's PTSD reactions one year after a sniper attack at their school. Am J Psychiatry. 1990;147:1526-1530. FREE FULL TEXT

Letters Section Editor: Robert M. Golub, MD, Senior Editor.

JAMA. 2006;296:2678.

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