PTSD

 

Clinical features

• Reliving the traumatic event with nightmares of flashbacks 
• Physical manifestations such as sweating, shaking, nausea/vomiting, pain. 
• Negative self-perception
• Emotional numbness
• Hyperarousal - hypervigilance, aggression and irritability 

  

Management

• Event debriefing and single session interventions following a traumatic event are not recommended.
• Mild symptoms (for < 4 weeks) - watchful waiting 
• Clinically important PTSD (mod-severe symptoms with functional impairment)
  • 1st line: Psychological therapy - trauma focussed CBT or EMDR (eye movement desensitisation and reprocessing) 
  • Drug treatment - if coexisting depression, declines or limited benefit from therapy - SSRI (sertraline) or venlafaxine. 
    • Risperidone can also be used in severe cases

 

Acute Stress Disorder

Clinical Features

• Symptoms similar to PTSD – but occurring within the first 4 weeks following trauma

 

Management

• 1st Line: Trauma based CBT
• Pharmacological management: Benzodiazepines may be of use