Posttraumatic stress disorder (PTSD)

In general

 * w>m (4:1)
 * the reaction is subjective
 * External stressor -> long-lasting stress reaction (acute stress disorder becomes PTSD)

What are possible stressors?

 * Actual death, treathened death, combat, raped, abused, neglect
 * Exposure: it can affect yourself or someone else (e.g. you can get PTSD if your child died) → Experienced, witnessed, learned, repeated aftermath (responders)

Clinical picture

 * Intrusion: intrusive thoughts: flashbacks, intrusive thoughts (recollection of psychotraumatic events)
 * Negative effect on mood and cognition: distorted memories, negative thoughts or expectations, constant negative emotions
 * Dissociation
 * avoidance: e.g. not talking about it, not going to the place
 * arousal: irritability (not anxiety, angry outbursts), hypervigilance, sleep disturbance

Diagnosis

 * is made clinical with the emphasis on ruling people in

Classification

 * Acute stress disorder: > 3 D but < 1 month
 * PTSD > 1 month
 * Adjustment disorder

Therapy

 * Psychotherapy (e.g. psychodynamic analysis, group therapy): the goal is here really to re-experience the trauma in a controlled manner and work through it
 * Eye movement desensitization and reprocessing (bilobal activation? desensitization?)
 * Pharmacotherapy
 * Prazosin: helps tremendously with insomnia and nightmares
 * SSRI, SNRI (usually reserved for people, who have either very severe symptoms or don´t want to do psychotherapy
 * if panic disorders occur: benzos

Complications

 * they can self-medicate (substance abuse) and develop mood disorders
 * can evolve into F62.0 enduring personality change
 * Suicide