Thursday, May 9, 2013


What is PTSD? 

Post-traumatic stress disorder or PTSD is an anxiety disorder associated with development of certain set of anxiety symptoms after a catastrophic stress. These symptoms remain after at least 1 month of onset to differentiate it from acute stress reaction another anxiety disorder occurring after similar catastrophic stress but remaining for less than 1 month. Symptoms of PTSD can occur with a delay of 1 week to 30 years.
Also referred to as combat neurosis or gulf war syndrome, the prevalence is about 8 percent with women being twice as susceptible as men.
Risk factors for PTSD
        1.      Catastrophic stressor such as wars, natural calamities, tortures and rapes.
        2.      Presence of childhood traumatic experiences  
        3.      Inadequate family support 
        4.      Alcohol
        5.      Genetic vulnerability
        6.      Neuro-chemical changes
        7.       Personality disorders
        8.       Female sex

Symptoms of PTSD

       1.      Recurrent distressing intrusive thoughts, dreams, images or perceptions.
       2.      Feeling as if traumatic event is recurring or flashbacks.    
       3.      Actively avoiding avoid activities, thought, and places related with event.
       4.      Impairment of socio-occupational functioning due to this.
       5.      Characteristics of hyper-arousal including increased startle responses, difficulty in sleep, anger outbursts, decreased concentration, and  hyper vigilance.
              6.       Severe physiological and psychological distress to cues.
Course of PTSD
About 33% improve, 33% remain same and rest 33% worsen if left untreated. Children and elderly have worst prognosis.

Treatment of PTSD

A psychiatric help is must for treatment of PTSD if a victim has been identified with suspicion of having PTSD.
Medicinal treatment include
         a)      SSRI’S such as paroxetine
         b)      TCA’S- imipramine and clomipramine
         c)      Buspirone
         d)      MAOI’S
         e)      Trazadone
         f)       Anti-convulsants- valproate and carbamazepine
         g)      Clonidine
         h)      Propranolol
Non medicinal treatment include
        a)      Systematic desensitization
        b)      EMDR
        c)      Behavior therapy
        d)      Cognitive therapy
Wishing you a very long and healthy life ahead
Dr Hitesh Sharma
MBBS, MD (Psychiatry)
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