Posttraumatic Stress Disorder - info for service users

Posttraumatic Stress Disorder

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What is Posttraumatic Stress Disorder?

Posttraumatic Stress Disorder or PTSD is a disabling anxiety disorder that people can develop following exposure to one or more traumatic events. Sufferers experience a combination of the following sorts of symptoms:

These symptoms develop after a traumatic event.

What is a traumatic event?

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. Examples may be:

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How common is PTSD?

Between 1990 and 1992 epidemiologists in the USA interviewed a sample of 8,098 Americans between the ages of 15 to 54 years that represent the population. They found that life-time prevalence of PTSD was 8%, with women (10%) twice as likely as men (5%) to have PTSD at some point in their lives.

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

The researchers concluded, "PTSD is a highly prevalent lifetime disorder that often persists for years. The qualifying events for PTSD are also common, with many respondents reporting the occurrence of more than a few such events during their lifetime" (Ronald C Kessler and colleauges 1995)

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Am I suffering from PTSD?

Have you experienced a trauma? Possibly one of the following:

Do you have any of these symptoms?

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Can PTSD be treated?

Yes, research indicates that individual psychological treatments are effective for posttraumatic stress disorder.

Our team and the Department of Psychiatry at Oxford University are world leaders in the treatment of PTSD. We have developed highly effective psychological treatments and have an ongoing research programme which aims to further the understanding and treatment of this condition.

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What should I do next to get help?

Consult your GP:

Firstly go to see your GP. Tell them about the symptoms you have been experiencing and that you think this is PTSD.

Referral

Ask your GP if there is local Traumatic Stress service you could be referred to. If not, ask to be referred you to your local Community Mental Health Team (CMHT).

This team should assess your needs, and if they are unable to treat you locally they could refer you direct to a Specialist Service nearest to your home.

There are various referral routes to our service, but it does depend on your GP's registered address and the service agreements our hospital has agreed with your local Primary Care Trust (PCT). In general if your GP is based in the boroughs of Lambeth, Southwark or Lewisham you can ask your GP to refer you to our clinic for assessment.

When we receive your referral a consultant in our team will review it to decide that you would be suitable for an assessment. We will write to notify you and the referrer and we will invite you to contact the Centre so that we can offer you a choice of appointment dates.

It should be noted that specialist services such as ours do have rather lengthy waiting lists, but at this service we do endeavour to offer you a choice of appointment dates within 13 weeks of the date of the authorised referral.

Assessment

Once you have accepted an appointment you will be sent out some questionnaires covering different aspects of PTSD, anxiety and depression to fill in and bring to your assessment. You will also of course receive a map and directions to the Centre.

We will write back to your referrer after we have completed the assessment and made decisions about your care. We have a policy whereby if you wish to be copied in on letters we are happy to do so with your signed consent.

If, at assessment, we do not feel we are able to help you then we tell you the reasons for this and make suggestions as to what would seem more helpful ways for you to proceed towards getting help with your problems.

Treatment

If we feel we are able to help you with your problems we will discuss the treatment with you. There might be some delay before we are able to start your therapy. This is due to the high demand for this service.

We would offer suggestions to your referrers about management of your care in the meantime, if this is appropriate.

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Are there support groups I could 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

Information for health care professionals

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 Yvette Yeboah on 020 7848 5047 or e-mail yvette.yeboah@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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