Post traumatic stress disorder

Question 1

Define PTSD?

Answer 1

Delayed or protected response to a experience of life threatening or catastrophic event, likely to cause pervasive stress in almost anyone.

Question 2

When does it usually present?

Answer 2

1-6 months in aftermath

Question 3

Risk factors? (5)

Answer 3

genetic link
previous traumatic events
reduced education
reduced socio-economic class
PMH and FH of neurotic disorders

Question 4

Clinical symptoms?

Answer 4

Hyperarousal: sleep disturbances, irritability or anger, exaggerated startled response, hypervigilance (enhanced state of sensory sensitivity)

Re-experiencing: nightmares, flashbacks
Avoidance: of activities associated with stressor
Inability to recall: parts or all of period exposed to stressor
Emotional numbing: lack of ability to experience feeling, feeling detached

Anxiety and depressive symptoms

Question 5

Psychological Mx? (4)

Answer 5

Watchful waiting for mild symptoms lasting less than 4 weeks
Trauma associated CBT
EMDR (eye movement desensitisation and reprocessing)
Psychodynamic therapy

Question 6

What medication can be given? (2)

Answer 6

A/D e.g. paroxetine (SSRI) or mirtazapine (NASSA)

Question 7

Prognosis?

Answer 7

50% recover within 1st year