Post-traumatic stress disorder

Question 1

Features

Answer 1

PTSD is the symptoms of acute stress disorder persistent for 3–6 m after exposure.

Delayed PTSD is onset of symptoms at least 6 m after the stressor.

PTSD has a cluster of three features:

1. re-experiencing symptoms e.g. nightmares, flashbacks
2. hyperarousal phenomenoma e.g. irritability, sleep disturbance
3. avoidance and numbing

Question 2

Treatment

Answer 2

This is difficult and involves counselling, the basis of which is facilitating abreaction of the experience by individual or group therapy.

The aim is to allow pt to face up openly to memories.

Persistent symptoms are an indication for referral for specialist-administered trauma-focused psychological therapy.

Question 3

Pharmacological treatment

Answer 3

There is no specific indication for drugs

but medication can have benefit in the treatment of;

• panic attacks
• generalised anxiety or
• depression.

A SSRI is the first-line agent, then mirtazapine.