Pharmacological interventions for preventing post-traumatic stress disorder (PTSD (original) (raw)
Related papers
Current Ideas Concerning the Aetiology and Treatment of Post-Traumatic Stress Disorder
Post-Traumatic Stress Disorder (PTSD) is a psychological condition that reflects the development of characteristic symptoms following exposure to high-magnitude life stressors. PTSD falls under Axis I of clinical syndromes in the DSM-IV and is recognised as an anxiety disorder. Anxiety disorders are the most common type of psychiatric diagnosis with 18% of the population meeting the DSM criteria for an anxiety disorder at some time. The World Health Organisation International Classification of Diseases of (ICD-10) criteria for PTSD is extremely similar to that of the DSM-IV, in particular involving the presence of a threatening event, which is thought to be necessary in the onset of the disorder. Both systems agree however, that it is the re-experiencing symptoms that are the identifying signs of PTSD which separate the disorder from most other psychopathology. This essay will commence with a brief overview of PTSD and its specifics, identifying the criteria necessary for diagnosis, gender differences and comorbidity of the anxiety disorder. This essay will then identify factors involved in the aetiology of PTSD and how biological, neurobiological, learning and cognitive factors may all influence the onset of PTSD due to a traumatic experience in the individuals’ life. This essay will then conclude with a critical appraisal of current ideas in the treatment of PTSD, such as; Cognitive-Behavioural Therapies (CBT), including Eye Movement Desensitisation and Reprocessing (EMDR), Behavioural Therapies including Exposure Therapy (ET), Cognitive Therapies including Cognitive Processing Therapy (CPT) and Pharmacotherapy. Utilising systematic reviews and meta-analysis, this essay will identify the efficacy of current ideas in treatment for PTSD.
A review of post-traumatic stress disorder. Part I: Historical development and classification
Injury-international Journal of The Care of The Injured, 1998
This paper describes the history of the development of understanding of psychological responses to traumatic life-events and their treatment. One major response, post-traumatic stress disorder (PTSD), is a recognized condition which has appeared relatizlely recently in diagnostic manuals. PTSD is a condition of major significance, root only to mental health professionals, but also to trauma surgeons and allied professionals. This paper focuses at1 t/w current definition of PTSD in the international Classificatioll of Diseases (ICD-10, 1992, World Health Organization) and the Diagnostic and Statistical Manual of the American Psychiatric Associatioil (DSM-IV, 1994). PTSD first appeared as an operational diagnosis in DSM-III (1980) and was revised it1 DSM-111-R (1987) and DSM-IV (2994). It made its first appearance in the ICD system later, in 1992. This paper seeks to irlcrease awaretless of PTSD across the broad spectrum of trauma management professionals, to emphasize the practical value of identifying the disorder and to encourage optimism for its treatment. This paper is in two parts. The first part deals with historical development and classification. The second part (to appenr in the next issue of injury) deals with treatment.
A review of post-traumatic stress disorder. Part II: Treatment
Injury-international Journal of The Care of The Injured, 1998
This paper describes the history of the development of understanding of psychological responses to traumatic life-events and their treatment. One major response, post-traumatic stress disorder (PTSD), is a recognized condition which has appeared relatizlely recently in diagnostic manuals. PTSD is a condition of major significance, root only to mental health professionals, but also to trauma surgeons and allied professionals. This paper focuses at1 t/w current definition of PTSD in the international Classificatioll of Diseases (ICD-10, 1992, World Health Organization) and the Diagnostic and Statistical Manual of the American Psychiatric Associatioil (DSM-IV, 1994). PTSD first appeared as an operational diagnosis in DSM-III (1980) and was revised it1 DSM-111-R (1987) and DSM-IV (2994). It made its first appearance in the ICD system later, in 1992. This paper seeks to irlcrease awaretless of PTSD across the broad spectrum of trauma management professionals, to emphasize the practical value of identifying the disorder and to encourage optimism for its treatment. This paper is in two parts. The first part deals with historical development and classification. The second part (to appenr in the next issue of injury) deals with treatment.
Posttraumatic Stress Disorder: Clinical Features, Pathophysiology, and Treatment
American Journal of Medicine, 2006
Posttraumatic stress disorder (PSTD), classified as an anxiety disorder, has become increasingly important because of wars overseas, natural disasters, and domestic violence. After trauma exposes the victim to actual or threatened death or serious injury, 3 dimensions of PTSD unfold: (1) reexperiencing the event with distressing recollections, dreams, flashbacks, and/or psychologic and physical distress; (2) persistent avoidance of stimuli that might invite memories or experiences of the trauma; and (3) increased arousal. Traumatic events sufficient to produce PTSD in susceptible subjects may reach a lifetime prevalence of 50% to 90%. The actual lifetime prevalence of PTSD among US citizens is approximately 8%, with the clinical course driven by pathophysiologic changes in the amygdala and hippocampus. Comorbid depression and other anxiety disorders are common. General principles of treatment include the immediate management of PTSD symptoms and signs; management of any trauma-related comorbid conditions; nonpharmacologic interventions including cognitive behavioral treatment; and psychopharmacologic agents including antidepressants (selective serotonin reuptake inhibitors most commonly), antianxiety medications, mood stabilizing drugs, and antipsychotics. This review of PTSD will provide the reader with a clearer understanding of this condition, an increased capacity to recognize and treat this syndrome, and a greater appreciation for the role of the internist in PTSD.
Understanding and treating PTSD: Introduction
Journal of Clinical Psychology, 2002
Although trauma and its consequences are not new, the understanding of the mental, emotional, and physical symptoms that often follow traumatic events as a distinct disorder is relatively recent. The addition of posttraumatic stress disorder (PTSD) to the Diagnostic and Statistical Manual of Mental Disorders (DSM-III) in 1980 had a large impact on theory, research, and treatment of the psychological consequences of trauma. Much of the early research focused on identification and assessment of symptomatic reactions to trauma and attempts to identify risk factors for the development of PTSD. Research on treatment of PTSD has emerged more recently and is still in the relatively early stages. Since the last edition of In Session on PTSD in 1997, there have been multiple advances in the treatment of PTSD. Most notable is research that has examined the efficacy of combined psychotherapy approaches in the treatment of PTSD and research that has compared the effectiveness of different treatments. Another area of growth has been the use of pharmacotherapy in the treatment of PTSD, especially the use of sertraline as an effective and well-tolerated treatment for PTSD. In the last few years, there also has been an increased interest among clinicians and researchers in eye-movement desensitization and reprocessing (EMDR) for patients with PTSD. The clinical significance of PTSD is reflected in the recent publications of experts' consensus statements on PTSD (e.g., Ballenger et al., 2000) and on practice guidelines for the treatment of PTSD (e.g., Foa, Keane, & Friedman, 2000). In the wake of the terrorist attacks on September 11, the effects of trauma have been featured prominently in the media and professional journals, and-hopefully-there will be a heightened importance of appropriate mental health care for trauma survivors. The purpose of this issue of In Session is to describe the theory and practice of the psychosocial approaches at the forefront in PTSD treatment, with plentiful case illustrations. The issue begins with an overview of clinically relevant research findings provided in the excellent article by Schnurr, Friedman, and Bernardy. With its summary of findings on the prevalence and course of PTSD, their article provides a context for understanding the importance of developing effective treatments. The discussion of the comorbidity associated with PTSD highlights one of the many complex issues in treatment in this
Asian Journal of Medical Sciences, 2013
Post-traumatic stress disorder (PTSD) is a serious debilitating syndrome with significant personal, social, and economic consequences. People with PTSD experience one or more major symptoms that include flashbacks and paranoia, difficulty in interpersonal relationships, and problems engaging in work and activities of daily living. In severe cases they can harm themselves or the others; but these events are preventable by appropriate therapies. PTSD is a well-characterized serious psychological and behavioural abnormality that occurs after exposure to one or more acute severe stressful events. It often occurs among soldiers returning from battlefields and the civilian victims of war. However, it also occurs in non-war situations, such as terrorist attacks or serious accidents; sexual abuse, rape, or other violent acts; and school or workplace bullying, harassment, or retaliation. Nevertheless, the diagnosis of PTSD is made too infrequently, particularly in the post-conflict periods i...
Posttraumatic stress disorder: acquisition, recognition, course, and treatment
Journal of …, 2004
Following exposure to trauma, a large number of survivors will develop acute symptoms of posttraumatic stress disorder (PTSD), which mostly dissipate within a short time. In a minority, however, these symptoms will evolve into chronic and persistent PTSD. A number of factors increase the likelihood of this occurring, including characteristic autonomic and hypothalamic-pituitary-adrenal axis responses. PTSD often presents with comorbid depression, or in the form of somatization, both of which significantly reduce the possibilities of a correct diagnosis and appropriate treatment. Mainstay treatments include exposure-based psychosocial therapy and selective serotonin reuptake inhibitors, such as paroxetine and sertraline, both of which have been found to be effective in PTSD. This paper looks at the course of PTSD, its disabling effect, its recognition and treatment, and considers possible new research directions.