PTSD

Question 1

What are the stressors that can contribute to PTSD?

Answer 1

1. Rape or criminal assault
2. Child abuse or severe neglect
3. Sudden unexpected loss of a loved one
4. Witnessing a trauma
5. Domestic violence
6. Serious accidents and natural disasters(floods, fires)
7. Hostage, imprisonment, torture

Question 2

Which occupations are associated with PTSD?

Answer 2

1. Police, firefighters, soldiers

Question 3

What are the pre-trauma risk factors of PTSD?

Answer 3

1. Gender- women are more susceptible
2. Age -adults younger than 25 years are more prone
3. Education: those with less education are more prone
4. Child abuse: sexual abuse and emotional neglect
5. Childhood adversity: socioeconomic poor
6. Adverse life events (divorce, ill health)\
7. psychiatric disorders( like personality disorders)
8. Genetics-family history of PTSD

Question 4

What are the trauma related factors that lead to PTSD?

Answer 4

1. Severity of the trauma
2. Type of trauma-46% of women that are raped experience PTSD
3. Betrayal-if the trauma is caused by a close contact instead of a stranger
4. participation in the trauma-witness or perpetrators

Question 5

What are the post-trauma factors that lead to the development of PTSD?

Answer 5

1. Poor social support after the trauma

Question 6

What are the two types of PTSD?

Answer 6

1. With dissociative symptoms
   This is present if the patient has PTSD with symptoms of depersonalization and dereaslisation

-depersonalization:
Experiences of feeling detached from and as if you’re observing your body or mental process from outside

Derealisation:
Experiences of unreality of the surroundings
-the patient feels that world is distant, dreamlike and unreal)

Question 7

When do we make a diagnosis of acute stress disorder?

Answer 7

When the patient presents with symptoms 3 days and just less than 1 month
-the presence of 9 out of 14 of the mentioned symptoms: intrusion, avoidance, arousal, negative mood, dissociation

Question 8

What are the associated conditions that patients with PTSD usually present with?

Answer 8

1. Major depressive disorder or persistent depressive disorder
2. Anxiety disorders like panic disorder, generalised anxiety disorder, OCD
3. Alcohol/drug dependence

Question 9

What is the differential diagnosis of PTSD?

Answer 9

1. Head injury, epilepsy, alcohol use and other substance disorders which can cause worse symptoms
2. Adjustment disorder, dissociative disorder, factitious and malingering disorder

Question 10

Which drugs must we avoid in PTSD?

Answer 10

Benzodiazepines