Anxiety Disorder: PTSD

Question 1

PTSD

Answer 1

Psychiatric disorder lasting > 4 weeks, triggered by exposure to traumatic events

Question 2

Pathophysiology of PTSD

Answer 2

Dysregulation of HPA axis:
1. abnormal corticol levels (heightened fear response)
2. increased amygdala activity (heightened fear response)
3. reduced hippocampal volume (memory impairment)

Question 3

Clinical features of PTSD

Answer 3

• re-experiencing: flashbacks, nightmares
• avoidance behaviours
• hyperarousal: hypervigilant, irritable, poor sleep, poor concentration
• emotional blunting and numbness
• depression, anger, drug and alcohol misuse

Question 4

Management of PTSD

Answer 4

• watching waiting up to 4 weeks post-onset
• trauma CBT
• eye movement desensitisation reprocessing (EMDR)
• SSRI (sertraline - never first line)