Post taumatic stress disorder

Question 1

ICD10 criteria for PTSD

Answer 1

Exposure to a situation of exceptional threatening nature that would likely cause distress in almost anyone
Reliving the situation e.g flashbacks, nightmares
Avoidance of reminders of stressor
Either inability to recall important aspects of traumatic event or symptoms of hyperarousal

Symptoms within 6 months from event

Question 2

Management for PTSD within 3 months from event

Answer 2

Identify comorbidities
Trauma focused CBT - imagine exposure in 1st person
Short term drug treatment for sleep disturbance

Question 3

Management for PTSD >3 months after event

Answer 3

Trauma focused CBT
Eye movement desensitisation and reprocessing- eye movements while holding image and negative cognition of trauma in mind
Pharmacological management if little benefit from psychotherapy or for comorbidities

Question 4

Pharmacological management of PTSD

Answer 4

Paroxetine - safe but weak evidence
Mirtazapine
Amitriptyline
Phenelzine (a MAOI)

Question 5

What is resilience

Answer 5

Ability to maintain stable equilibrium between normal functioning and psychopathology from traumatic event