PTSD Post Traumatic Stress Disorder

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PTSD Post Traumatic Stress Disorder

• Dr. Ismail Lunat

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PTSD

• Based on Nice Guidelines (2005)
• Can occur in any individual following stressful
  event or situation of an extremely threatening or
  catastrophic nature.
• Under recognised.
• Following terrorism, wars and extensive media
  coverage, there is increased acceptance. Also,
  the arrival of asylum seekers and refugees from
  war torn areas. 1

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Post Traumatic Stress Disorder (PTSD)

• No Wounds upon my body,
• No scars that you can find,
• Just hurt from wars fought long ago
• implanted in my mind
•  
• No outward signs of injury,
• No telltale signs of pain,
• Only flashbacks and the nightmares
• Time and Time again.
•  
• But alls not lost for us old friend
• There are those that understand
• Just let them lead us through the darkness
• Go with them hand in hand
•   P,T.S.D. is a state of the mind, that leaves
  our minds in a state
• Poem written by former soldier on www.ptsd.org.uk

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Diagnosis

• Typical symptoms
• DSM IV Criteria
• Exposure to a traumatic event, or series of
  events as well as symptoms from each of the
  following clusters
• Intrusive recollections
• Avoidant or numbing symptoms
• Hyperarousal, anxiety symptoms
• Symptoms persist for gt 1 month cause
  significant levels of distress or impairment in
  social functioning.

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What is a traumatic stressor?

• Experiences of soldiers, Sudden bereavement,
  traumatised images of death destruction on TV,
  bullying and abuse.
• Typical patients are frequent primary care users
  and have high rates of somatic symptoms. Not
  always presenting with classic PTSD symptoms, so
  screen

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Management

• Debriefing after disasters should not be routine
• Consider watchful waiting when symptoms are mild
  and lt4wks. Arrange follow-up in 1 months time.
• Trauma focused CBT if symptoms. If symptoms
  present gt3months after trauma- consider trauma
  focused psychological treatment (CBT or EMDR)
• Drugs (not routine 1st line) For use by mental
  health specialists
• Drugs inc Paroxetine, mirtazepine,
  amitryptilline. Treatment for 12 months

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Voluntary/charity organisations

• Department of Defence Mental Health (London)
• www.combatstress.com Charity organisation set
  up by the Ex Services Mental Welfare Society (80
  years service). They provide assessment and
  therapies inc CBT and EMDR (nice recommends)
• www.ptsd.org.uk set up by fellow PTSD sufferers
  and provide contact and links
• References
• 1 Ollf, M. Coping with the aftermath of trauma,
  Editorial, BMJ  20053301038-1039
• 2 Nice Guidelines www.nice.org.uk