Transcript post traumatic stress disorder

PTSD – Post Traumatic
Stress Disorder
Dr. Ismail Lunat
PTSD
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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
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 all’s 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
Diagnosis
Typical symptoms:
 DSM IV Criteria:
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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 > 1 month & cause significant
levels of distress or impairment in social functioning.
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
Management

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Debriefing after disasters should not be routine
Consider watchful waiting when symptoms are
mild and <4wks. Arrange follow-up in 1 months
time.
 Trauma focused CBT if symptoms. If symptoms
present >3months 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
Voluntary/charity organisations
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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 2005;330:1038-1039
2 Nice Guidelines: www.nice.org.uk