Post-Traumatic Stress Disorder

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Clinical Description

PTSD is a disorder that may occur in individuals that have been exposed to actual, threatened, repetitive or serious threat / violence.

Clinical Features

SIGNS AND SYMPTOMS

• Intrusive symptoms e.g., nightmares, flashbacks
• Avoidance behaviors e.g., people, places that are reminders
• Negative changes in mood and cognition e.g., shame, guilt, dissociative amnesia (poor recollection of important aspects of the traumatic event etc.)
• Hyperarousal e.g., sleep disturbances, irritability, reckless and self-destructive behavior

INVESTIGATIONS

• Ensure patient has had relevant physical assessment and investigations e.g., gynecology assessment in individuals who have been sexually assaulted
• Assess for psychiatric comorbidity including depression, alcohol and drug use and suicidality

Treatment

• Educate the patient or family on condition
• Avoid psychological debriefing in immediate aftermath of traumatic event
• Use Cognitive behavior therapy (trauma-focused)
• Prescribe Selective Serotonin Reuptake Inhibitor Antidepressants e.g., Fluoxetine 20-60mg once daily for 6 months

FOLLOW UP

• Continue follow-up and monitor for substance abuse and suicidality
• Refer patient if poor response to treatment