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Post-traumatic stress disorder

Symptoms and Associated Conditions: – Symptoms of PTSD typically begin within three months of a traumatic event. – Individuals may avoid trauma-related thoughts and emotions. […]

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Symptoms and Associated Conditions:
– Symptoms of PTSD typically begin within three months of a traumatic event.
– Individuals may avoid trauma-related thoughts and emotions.
– PTSD can lead to amnesia of the traumatic event.
– Common symptoms include flashbacks and nightmares.
– PTSD symptoms must persist for over a month for diagnosis.
– Trauma survivors often develop depression, anxiety disorders, and mood disorders.
– Over 50% of individuals with PTSD have co-morbid anxiety, mood, or substance use disorders.
– PTSD is strongly linked to substance use disorders like alcohol use disorder.
– Emotional regulation difficulties are associated with post-traumatic stress symptoms in children and adolescents.

Risk Factors and Trauma Types:
– Combat military personnel, natural disaster survivors, and violent crime survivors are at risk for PTSD.
– Occupations exposing individuals to violence or disasters increase PTSD risk.
– Intensity of the traumatic event is associated with the risk of PTSD.
– Witnessing death, torture, injury, or traumatic brain injury increases PTSD risk.
– Unexpected or inescapable traumatic events are linked to a high risk of PTSD.
– PTSD is linked to various traumatic events, with different risks associated with each type.
– Sexual violence exposure has the highest risk of PTSD development.
– Men are more likely to experience trauma, while women are more likely to experience high-impact traumatic events.
– Survivors of motor vehicle collisions are at increased risk of PTSD.

Prevention and Treatment:
– Prevention may be possible with targeted counseling for early symptoms.
– Counseling and medication are the main treatments for PTSD.
– Antidepressants of the SSRI or SNRI type are commonly used for PTSD.
– Medication benefits are lower than those of counseling.
– Combined medication and counseling benefits are uncertain.

Pathophysiology and Genetics:
– PTSD symptoms may result from an over-reactive adrenaline response.
– High stress hormone levels suppress hypothalamic activity.
– PTSD causes biochemical changes in the brain and body.
– Individuals with PTSD show low cortisol secretion and high catecholamines.
– Abnormalities in the hypothalamic-pituitary-adrenal axis are implicated.
– Susceptibility to PTSD is hereditary.
– Approximately 30% of PTSD variance is genetic.
– Twin pairs with a monozygotic twin with PTSD have increased risk.
– Women with smaller hippocampus may be more likely to develop PTSD.
– PTSD shares genetic influences with other psychiatric disorders.

Diagnosis and Assessment:
– Diagnostic criteria for PTSD are subjective.
– Potential for both over-reporting and under-reporting of symptoms.
– PTSD diagnosis can overlap with other mental disorders.
– Various screening and assessment tools are available.
– Official PTSD diagnosis is provided through assessments.
– PTSD reclassified from an anxiety disorder to a trauma- and stressor-related disorder in DSM-5.
– ICD-10 and ICD-11 criteria and changes for PTSD diagnosis.
– Differential diagnosis includes adjustment disorder, acute stress disorder, obsessive-compulsive disorder, and complex post-traumatic stress disorder.

Post-traumatic stress disorder (Wikipedia)

Post-traumatic stress disorder (PTSD) is a mental and behavioral disorder that develops from experiencing a traumatic event, such as sexual assault, warfare, traffic collisions, child abuse, domestic violence, or other threats on a person's life or well-being. Symptoms may include disturbing thoughts, feelings, or dreams related to the events, mental or physical distress to trauma-related cues, attempts to avoid trauma-related cues, alterations in the way a person thinks and feels, and an increase in the fight-or-flight response. These symptoms last for more than a month after the event. Young children are less likely to show distress, but instead may express their memories through play. A person with PTSD is at a higher risk of suicide and intentional self-harm.

Post-traumatic stress disorder
SpecialtyPsychiatry, clinical psychology
SymptomsDisturbing thoughts, feelings, or dreams related to the event; mental or physical distress to trauma-related cues; efforts to avoid trauma-related situations; increased fight-or-flight response
ComplicationsSuicide; cardiac, respiratory, musculoskeletal, gastrointestinal, and immunological disorders
Duration> 1 month
CausesExposure to a traumatic event
Diagnostic methodBased on symptoms
TreatmentCounseling, medication, MDMA-assisted psychotherapy, selective serotonin reuptake inhibitors
Frequency8.7% (lifetime risk); 3.5% (12-month risk) (US)

Most people who experience traumatic events do not develop PTSD. People who experience interpersonal violence such as rape, other sexual assaults, being kidnapped, stalking, physical abuse by an intimate partner, and childhood abuse are more likely to develop PTSD than those who experience non-assault based trauma, such as accidents and natural disasters. Those who experience prolonged trauma, such as slavery, concentration camps, or chronic domestic abuse, may develop complex post-traumatic stress disorder (C-PTSD). C-PTSD is similar to PTSD, but has a distinct effect on a person's emotional regulation and core identity.

Prevention may be possible when counselling is targeted at those with early symptoms, but is not effective when provided to all trauma-exposed individuals regardless of whether symptoms are present. The main treatments for people with PTSD are counselling (psychotherapy) and medication. Antidepressants of the SSRI or SNRI type are the first-line medications used for PTSD and are moderately beneficial for about half of people. Benefits from medication are less than those seen with counselling. It is not known whether using medications and counselling together has greater benefit than either method separately. Medications, other than some SSRIs or SNRIs, do not have enough evidence to support their use and, in the case of benzodiazepines, may worsen outcomes.

In the United States, about 3.5% of adults have PTSD in a given year, and 9% of people develop it at some point in their life. In much of the rest of the world, rates during a given year are between 0.5% and 1%. Higher rates may occur in regions of armed conflict. It is more common in women than men.

Symptoms of trauma-related mental disorders have been documented since at least the time of the ancient Greeks. A few instances of evidence of post-traumatic illness have been argued to exist from the seventeenth and eighteenth centuries, such as the diary of Samuel Pepys, who described intrusive and distressing symptoms following the 1666 Fire of London. During the world wars, the condition was known under various terms, including 'shell shock', 'war nerves', neurasthenia and 'combat neurosis'. The term "post-traumatic stress disorder" came into use in the 1970s, in large part due to the diagnoses of U.S. military veterans of the Vietnam War. It was officially recognized by the American Psychiatric Association in 1980 in the third edition of the Diagnostic and Statistical Manual of Mental Disorders (DSM-III).

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