PTSD - info for health professionals

Posttraumatic Stress Disorder

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What is Posttraumatic Stress Disorder

Posttraumatic stress disorder (PTSD) is a disabling anxiety disorder that people might develop following exposure to one or more traumatic events. A trauma is an event that causes intense fear during which the individual may feel like they (or someone very close to them) are about to die or experience serious harm. Traumatic events go beyond daily stressful events. These include:

PTSD sufferers present with the following symptoms:

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How common is PTSD?

According to the Diagnostic and Statistical Manual of Mental Disorders (1994) the lifetime prevalence for Posttraumatic Stress Disorder based on community studies ranges from 1% to 14%, with the variability related to methods of ascertainment and the population sampled. Studies of at-risk groups e.g. combat veterans, victims of natural disasters or criminal violence have yielded prevalence rates ranging form 3% to 58%.

The study found that 61% of men and 51% of women reported that they have experienced at least one traumatic event in their lives.

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Can PTSD be treated?

PTSD can be treated effectively with psychological treatments that have been specifically designed for the treatment of PTSD, and these treatments have been recently recommended by The National Institute of Clinical Excellence (NICE) as the treatment of choice for PTSD sufferers (PTSD Guideline March 2005). Our team at the Centre for Anxiety Disorders and Trauma and the Department of Psychiatry at Oxford University have been involved in developing such treatments, and we have an ongoing research programme which aims to further the understanding and treatment of the disorder.

We are currently running a randomised controlled trial comparing different versions of psychological treatments for PTSD.

Drug Treatment?

The psychological treatments for PTSD offered at the Centre for Anxiety Disorders and Trauma are usually effective without additional medication in the treatment of PTSD. Although people with PTSD sometimes benefit from medication, we prefer if service users referred to the Centre for Anxiety Disorders and Trauma are not simultaneously put on medication.

Many service users with PTSD are also depressed. This does not necessarily mean that they need anti-depressive medication. The psychological treatments for PTSD offered at the Centre for Anxiety Disorders and Trauma have been shown to treat depressive as well as the PTSD symptoms. Only if the depression is so severe that it makes it unlikely for the service user to benefit from the psychological treatment, we recommend concurrent drug treatment.

For further information about medication in PTSD we refer to the PTSD Guidelines published by the National Institute of Clinical Excellence (2005) (National Institute for Clinical Excellence). The only drugs recommended for general use are paroxetine and mirtazepine. Amitriptyline or phenelzine (with the dietary guideline) are recommended for initiation only by mental health specialists

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Where can I refer a service user with PTSD?

You can call Francesca Brady on 020 7848 5047 or e-mail francesca.brady@kcl.ac.uk to disucss possible referrals.

If you are in the catchment area of South London and Maudsley (SLAM) NHS Trust you can refer your service user to our clinic. Referrals should be sent to:

Margaret Dakin
Centre for Anxiety Disorders and Trauma
99 Denmark Hill
London SE5 8AZ

Please note that we do not accept referrals of people who have recently been prescribed medication in connection with their anxiety problems. Any medication of this type must have been at a stable dose for two months.

If you are not practicing in our catchment area you could still refer service users to our research programme.

Please note that we do not treat PTSD as a result of childhood trauma, we only treat PTSD as a result of trauma experienced as an adult. If you suffer from PTSD as a consequence of a childhood trauma you should contact the Traumatic Stress Service based at the Maudsley Hospital.

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Are there support groups service users can contact?

VICTIM SUPPORT

Offer support to all victims of crimes. They can arrange counselling and they are very well versed in court procedures. See phone book for details of local branch or ring the national helpline on 084530 30 900 or have a look at their website www.victimsupport.org.uk

UK TRAUMA GROUP

www.uktrauma.org.uk includes listings of specialist UK trauma services.

RAPE CRISIS

Offering advice, support and counselling. You can learn more about this organisation by looking at their website www.rapecrisis.org.uk You can call the London Rape Crisis office on 0115 934 8474.

SAMARITANS

Tel: 08457 90 90 90 (UK) and 1850 60 90 90 (ROI)

Anonymous e-mail:jo@samaritans.org

Website http://www.samaritans.org.uk

Anxiety UK (formerly National Phobics Society)

Zion Community Resource Centre, 339 Stretford Road, Hulme, Manchester, M15 4ZY

Tel: 08444 775 774

www.anxietyuk.org.uk

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