PTSD Flashcards
Define PTSD.
Intense, delayed, prolonged reaction to stressful stimulus. Event is likely to cause pervasive distress in anyone and usually involves threat to self.
Explain the aetiology/risk factors of PTSD.
Traumatic event (i.e. rape, death, war, torture). May be due to:
- Event challenges held beliefs, resulting in inability to cognitively rationalise
- May be due to normal processing of emotionally charged information leading to overwhelming feeling and memories.
- Negative appraisal of intrusive thoughts, leading to lack of processing and therefore maintaining symptoms over time.
Between 10 and 25% of those exposed to stress event develop PTSD. Subjective meaning of event is one of the most important factors for development.
Summarise the epidemiology of PTSD.
Higher risk if childhood trauma, PD, support system, recent stressful events, female, low SES, past psych hx. Lifetime incidence 1-3%. War veterans 30%.
What are the 3 main symptoms which arise from PTSD?
Hyperarousal
Intrusions
Avoidance
What are the signs of hyperarousal?
Persistent anxiety
Hypervigilance
Poor concentration
Insomnia
Irritability
Exaggerated startle
What are the signs of intrusion?
Flashback
Nightmare
Vivid memories
Frequent thought of incident
What are the signs of avoidance?
Avoid reminders
Unable to recall details
Poor interest
Emotional detachment
Avoids talking about it
How might a PTSD patient appear on examination?
Neglect
Depression
Anxiety
Hypervigilant
Poor eye contact
Tearful
Slow speech
Low mood
Poor concentration
What are investigations for PTSD?
FBCs
U+Es
LFTs
Ca2+
TFTs
What is the management for PTSD?
Screen for comorbidities
Risk assessment for suicide
CBT
Challenging dysfuncitonal thoughts and talking
Eye movement desensitization reprocessing (recall event)
SSRI
What are the complications associated with PTSD? What is the prognosis of PTSD?
Social withdrawal
Suicide
Alcohol
Drug use
Half make good recovery in 1y, rest may have lifelong symptoms
