PTSD, ASR, AD and complex PTSD Flashcards
Mnemonic for PTSD in ICD 11
TRAUMA
esessial features for PTSD on ICD 11?
TRAUMA for Several weeks
T- Trauma (short or long-lasting but extremely threatening)
R-Re experiencing
A-Avoiding
U-Unpleasant Change
M-Marked Arousal
A-Adjustment issue
Emotional expeirences with PTSD?
Anger
Sadness
Shame
Guilt (even survivor guilt)
Humiliation
Common symptomatic presentation of PTSD?
Dysphoria
Dissociative symptoms
Somatic complaints
Suicidal ideation & behaviours
Social withdrawal
Substance abuse to avoid re-exper. or manage emotion
Anxiety symptoms
dysphoria symptoms in PTSD include
‘loss of interest’, ‘emotional detachment’, ‘difficulty concentrating’, ‘irritability’, ‘sleep disturbance’
Anxiety symptoms in PTSD
panics
OC responds to memories or reminders
when can PTSD onset being
any time after the trauma during life time
when can PTSD onset being typically
within 3 months
Is actue stress reation coded with PTSD in ICD 11?
no!
(Problem associated with harmful events)
why actute stress related is separted from PTSD?
to emphasise that an acute stress reaction is a normal reaction with no pathology
Mnemonic for Acute Stress Reaction in ICD 11?
SHOCK
Essential features of Acute stress reaction?
SHOCK
S-Symptoms like (emotional, somatic, cognitive or behavioural and autonomic)
H-Hypo-flash backs
O-Over within days (1 month)
C- Circumstance of trauma same as PTSD
K-knows how to adapt later
Main difference between PTSD and acute distress reaction?
The latter is associated with symptoms subsiding within 1 month
Mnemonic for Adjustment disorder (AD) in ICD 11
ADJUST
Essential features of Adjustment disorder (AD) in ICD 11
ADJUST
A-Adaptive problem
D-Distress
J-Justification not (for symptoms)
U-Underlying factor happened in 3 months
S- Signficant Impairmenet
T- Temporary, resolves within 6 months
Difference between PTSD & AD?
Trauma is much much much severe in PTSD
Though symptoms could be similar in both
Similarity between PTSD & AD?
Rumination about stressor (w/out nightmares & flashbacks)
Avoidance of triggers and reminders
Somatic, cognitive and emotional symptoms
when do AD symptoms resolve according to ICD 11?
within 6 months
Mnemonic for Complex PTSD in ICD 11
COMPLEX
Essential features of Complex PTSD in ICD 11
COMPLEX
C-Core Features of PTSD
O-Occurring or re occurring Trauma
M-Mood disturbance
P-Personal relationships issues
L-Loss of self
E-Emotional dysregulation
X-Xpereinc distress
what are core features of PTSD according to ICD 11?
-Re experience
-Avoidance
-Hyperarousal
what does hyperarousal include in ICD 11?
Hypervigilance
Enhanced startle
difference between PTSD and complex PTSD in startles?
Unlike in PTSD, startles in complex PTSD might be diminished rather than enhanced.
what are core features that are required to differentiate Complex PTSD from PTSD?
-Emotional dysregulation
-Negativity about self
-Interpersonal issues
Is psychological debriefing allowed in PTSD?
No not recommended
PTSD less than one month in children and young
active monitoring
PTSD at least 1 months in children and young
Trauma-focused CBT
PTSD for 3 months in 7-17 years old who not responded to or refused Trauma-focused CBT?
EMDR
what is EMDR
Eye Movement Desensitization & Reprocessing
Drugs in PTSD >18 years old
no! Do not offer
PTSD 1st line Rx in adults
Trauma-focused CBT
when EMDR is 1st line Rx in PTSD in adults?
if the trauma is not combat related and patient prefers it over CBT
when is computerized CBT 1st line treatment in PTSD in adults
if there is not significant risk of harm ( to self or others)
If PTSD is not severe
Which drug class is recommended to avoid in prevention of PTSD in adults?
Benzodiazepam
why benzo are not recommended in PTSD prevention?
worse overall severity
significantly increased risk of developing PTSD with use after recent trauma
worse psychotherapy outcomes
aggression
depression
substance use
when can we use Drugs in PTSD?
if they have preference for drugs
what drugs can be used in PTSD?
Venlafaxine & SSRIs
is drug treatment the 1st line treatment in PTSD?
Nope
What SSRIs are best for PTSD in case preferred?
Paroxetine & Fluxetine
when one can consider adding antipsychotics for PTSD?
if not enough response to other treatment (pharma & non-pharma)
disabling symptoms
psychotic symptoms
waht antipsychotics are used when needed in PTSD?
Risperidone
what off-license Rx is used for nightmares in PTSD
Prazosin
what is prazosin
Alpha-1 adrenergic receptor antagonist
what does Prazosin do?
reduces andrenaline activity ===» reduces arounsal and anxiety
what is the signficant of nightmares in PTSD
-Resistant to treat generally
-Associated with suicidality
Fluoxetine Rx in PTSD : Dose (MAUDSLEY 14th)
up to 60 mg might be required
Fluoxetine Rx in PTSD: Duration (MAUDSLEY 14th)
at least 6 months after remission
Fluoxetine Rx in PTSD : Response time (MAUDSLEY 14th)
within 8 weeks but maybe 12 weeks
Risk factor of PTSD in children and adolescent
those attending emergency departments
in forensic settings
or among refugee/asylum seekers.
The Maudsley
what risks are youg people are associated with in PTSD?
- self-harm (50%)
-Suicide attempt (20%)
-Functionally impaired
