Post-traumatic stress disorder
Post-Traumatic Stress Disorder
Post-traumatic stress disorder (PTSD), once called shell shock or battle fatigue syndrome, is a serious condition that can develop after a person has experienced or witnessed a traumatic or terrifying event in which serious physical harm occurred or was threatened, and in more serious cases, death was perceived as imminent. PTSD is a lasting consequence of traumatic ordeals that may cause intense fear, helplessness, or anxiety, such as a sexual or physical assault, the unexpected death of a loved one, an accident, war, or natural disaster. Families of victims can also develop post-traumatic stress disorder, as can emergency personnel, rescue workers fire fighters and police officers.
Most people who experience a traumatic event will have reactions that may include shock, anger, nervousness, fear, and even guilt. These reactions are common; and for most people, they go away over time. For a person with PTSD, however, these feelings continue and even increase, becoming so strong that they keep the person from living a normal life. People with PTSD have symptoms for longer than one month and cannot function as well as before the event occurred.
Symptoms
Symptoms of PTSD most often begin within three months of the event. In some cases, however, they do not begin until years later. The severity and duration of the illness vary. Some people recover within six months, while others suffer much longer.
Symptoms of PTSD often are grouped into three main categories, including:
- Re-living: People with PTSD repeatedly re-live the ordeal through thoughts and memories of the trauma. These may include flashbacks, hallucinations, and nightmares. They also may feel great distress when certain things remind them of the trauma, such as the anniversary date of the event.
- Avoidence: The person may avoid people, places, thoughts, or situations that may remind him or her of the trauma. This can lead to feelings of detachment and isolation from family and friends, as well as a loss of interest in activities that the person once enjoyed.
- Increased arousal (hyper-vigilence): These include excessive emotions; problems relating to others, including feeling or showing affection; difficulty falling or staying asleep; irritability; outbursts of anger; difficulty concentrating; and being "jumpy" or easily startled. The person may also suffer physical symptoms, such as increased blood pressure and heart rate, rapid breathing, muscle tension, nausea, and diarrhea (or, irritable bowel syndrome).
At Risk
Everyone reacts to traumatic events differently. Each person is unique in thier ability to manage fear and stress, and to cope with the threat posed by a traumatic event or situation. For that reason, not everyone who experiences or witnesses a trauma will develop PTSD. Further, the type of help and support a person receives from friends, family members and professionals following the trauma may influence the development or non-development of PTSD as well as the severity of symptoms.
PTSD was first brought to the attention of the medical community by war veterans, hence the names shell shock and battle fatigue syndrome. However, PTSD can occur in anyone who has experienced a traumatic life threatening event. People who have been abused as children or who have been repeatedly exposed to life-threatening situations are at greater risk for developing PTSD and other anxiety related illnesses.[1]
Epidemiology
The lifetime prevalence of PTSD is 8% in the United States.[2]
On a population scale, PTSD can occur following natural or man-made disasters.[3] PTSD has been noted following the Indian Ocean tsunami in 2004 and hurricane Katrina in 2005. [3]
Diagnosis
A 4-item screen for PTSD in patients with depression has been investigated.[4]
Co-morbidity
Background
Data were obtained on the general population epidemiology of DSM-III-R posttraumatic stress disorder (PTSD), including information on estimated lifetime prevalence, the kinds of traumas most often associated with PTSD, sociodemographic correlates, the comorbidity of PTSD with other lifetime psychiatric disorders, and the duration of an index episode.
Methods
Modified versions of the DSM-III-R PTSD module from the Diagnostic Interview Schedule and of the Composite International Diagnostic Interview were administered to a representative national sample of 5877 persons aged 15 to 54 years in the part II subsample of the National Comorbidity Survey.
Results
The estimated lifetime prevalence of PTSD is 7.8%. Prevalence is elevated among women and the previously married. The traumas most commonly associated with PTSD are combat exposure and witnessing among men and rape and sexual molestation among women. Posttraumatic stress disorder is strongly comorbid with other lifetime DSM-III-R disorders. Survival analysis shows that more than one third of people with an index episode of PTSD fail to recover even after many years.
Conclusions
Posttraumatic stress disorder is more prevalent than previously believed, and is often persistent. Progress in estimating age-at-onset distributions, cohort effects, and the conditional probabilities of PTSD from different types of trauma will require future epidemiologic studies to assess PTSD for all lifetime traumas rather than for only a small number of retrospectively reported "most serious" traumas.
Treatment
- Cognitive behavioral therapy with a trained psychiatrist, psychologist, or other professional can help change emotions, thoughts, and behaviors associated with PTSD and can facilitate managing panic, anger, and anxiety.
- Certain medications can reduce symptoms such as anxiety, impulsivity, depression, and insomnia and decrease urges to use alcohol and other drugs.
- Group therapy can help patients learn to communicate their feelings about the trauma and create a support network.
- Becoming informed about PTSD and sharing information with family and friends can create understanding and support during recovery.
External links
- Journal of the American Medical Association (JAMA) patient page. Posttraumatic stress disorder
References
- ↑ http://www.webmd.com/anxiety-panic/guide/post-traumatic-stress-disorder
- ↑ Kessler RC, Sonnega A, Bromet E, Hughes M, Nelson CB (1995). "Posttraumatic stress disorder in the National Comorbidity Survey". Arch. Gen. Psychiatry 52 (12): 1048–60. PMID 7492257. [e]
- ↑ 3.0 3.1 Satcher D, Friel S, Bell R (2007). "Natural and manmade disasters and mental health". JAMA 298 (21): 2540–2. DOI:10.1001/jama.298.21.2540. PMID 18056908. Research Blogging.
- ↑ Gerrity MS, Corson K, Dobscha SK (2007). "Screening for posttraumatic stress disorder in VA primary care patients with depression symptoms". J Gen Intern Med 22 (9): 1321–4. DOI:10.1007/s11606-007-0290-5. PMID 17634781. Research Blogging.