Food and Drug Administration for the treatment of PTSD. Currently, paroxetine (Paxil) and sertraline (Zoloft) are the only medications that have been approved by the U.S. Recent interest in the treatment of PTSD has stimulated large, prospective, double-blind, placebo-controlled clinical trials of the efficacy of selective serotonin reuptake inhibitors (SSRIs) in the treatment of the symptoms of PTSD. With delayed onset: If onset of symptoms is at least six months after the stressor. The disturbance causes clinically significant distress or impairment in social, occupational, or other important areas of function.Īcute: If duration of symptoms is less than three months.Ĭhronic: If duration of symptoms is three months or more. Duration of the disturbance (symptoms in Criteria B, C, and D) is more than one month.į. Persistent symptoms of increased arousal (not present before the trauma), as indicated by two (or more) of the following:Į. Sense of a foreshortened future (e.g., does not expect to have a career, marriage, children, or a normal life span).ĭ. Restricted range of affect (e.g., unable to have loving feelings).ħ. Feeling of detachment or estrangement from others.Ħ. Markedly diminished interest or participation in significant activities.ĥ. Inability to recall an important aspect of the trauma.Ĥ. Effort to avoid activities, places, or people that arouse recollections of the trauma.ģ. Effort to avoid thoughts, feelings, or conversations associated with the trauma.Ģ. Persistent avoidance of stimuli associated with the trauma and numbing of general responsiveness (not present before the trauma), as indicated by three (or more) of the following:ġ. Physiologic reactivity on exposure to internal or external cues that symbolize or resemble an aspect of the traumatic event.Ĭ. Intense psychologic distress at exposure to internal or external cues that symbolize or resemble an aspect of the traumatic event.ĥ. note: In young children, trauma-specific reenactment may occur.Ĥ. Acting or feeling as if the traumatic event were recurring (includes a sense of reliving the experi ence, illusions, hallucinations, and dissociative flashback episodes, including those that occur on awakening or when intoxicated). note: In children, there may be frightening dreams without recognizable content.ģ. Recurrent distressing dreams of the event. note: In young children, repetitive play may occur in which themes or aspects of the trauma are expressed.Ģ. Recurrent and intrusive distressing recollections of the event, including images, thoughts, or perceptions. The traumatic event is persistently re-experienced in one (or more) of the following ways:ġ. note: In children, this may be expressed instead by disorganized or agitated behavior.ī. The person's response involved intense fear, helplessness, or horror. The person experienced, witnessed, or was confronted with an event or events that involved actual or threatened death or serious injury, or a threat to the physical integrity of self or others.Ģ. The person has been exposed to a traumatic event in which both of the following were present:ġ. Selective serotonin reuptake inhibitors are the mainstay of pharmacologic treatment.Ī. Treatment relies on a multidimensional approach, including supportive patient education, cognitive behavior therapy, and psychopharmacology. The most common comorbid disorders include depression, alcohol and drug abuse, and other anxiety disorders. Approximately 80 percent of patients with PTSD have at least one comorbid psychiatric disorder. Before a diagnosis of PTSD can be made, the patient's symptoms must significantly disrupt normal activities and last for more than one month. The emotional and physical symptoms of PTSD occur in three clusters: re-experiencing the trauma, marked avoidance of usual activities, and increased symptoms of arousal. The lifetime prevalence of PTSD in the United States is 8 to 9 percent, and approximately 25 to 30 percent of victims of significant trauma develop PTSD. Although post-traumatic stress disorder (PTSD) is a debilitating anxiety disorder that may cause significant distress and increased use of health resources, the condition often goes undiagnosed.
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