Prognosis varies many patients recover within months while some have symptoms that persist for years.These include substance use disorder, sleep difficulties, depression, anxiety, and social and occupational dysfunction r1 Comorbid conditions and PTSD complications can cause significant distress.Evidence-based therapeutic modalities include prolonged exposure therapy, cognitive processing therapy, and eye movement desensitization and reprocessing r4 r5.First line treatment is trauma-focused psychotherapy and/or serotonin reuptake inhibitors (eg, paroxetine, sertraline, venlafaxine). Ideally, diagnosis is confirmed by a trained mental health practitioner (eg, psychologist, psychiatrist, clinical social worker), often aided by a semistructured interviewing tool r2 r3 When suspected based on patient history, primary care clinicians can identify probable PTSD with a validated screening questionnaire, such as PC-PTSD-5 (Primary Care PTSD Screen for DSM-5).DSM-5-TR criteria are diagnostic for PTSD r1.Risk factors for PTSD (posttraumatic stress disorder) include occupational exposure to trauma (eg, military personnel, firefighters, police officers) threatened or actual physical or sexual assault being kidnapped or held hostage, a prisoner of war, or tortured experiencing natural or man-made disaster, interpersonal violence, a severe motor vehicle crash, or a sudden medical catastrophic event or witnessing a very stressful or traumatic event.Separate criteria have been added for children aged 6 years or younger. Diagnostic criteria have been suitable for children and adolescents. There are new symptoms, namely persistent negative beliefs and expectations about oneself or the world, persistent negative trauma-related emotions, and risky or reckless behaviors. The American Psychiatric Associations Diagnostic and Statistical Manual of Mental Disorders (DSM) is a classification of mental disorders with associated criteria designed to facilitate more reliable diagnoses of these disorders. The number of symptoms increased from 17 in DSM-IV to 20 in DSM-5. To satisfy the criteria for PTSD, there must be a minimum number of symptoms from each cluster: at least one of five re-experiencing symptoms, one of two avoidance symptoms, three of seven cognitions and mood symptoms, and three of six hyperarousal symptoms. Published on behalf of the International Society for Traumatic Stress Studies. There are four PTSD symptom clusters (There were three in DSM IV) a) Intrusion symptoms including dissociative reactions (dissociative reactions are şashbacks, derealization, and depersonalization.) b) avoidance symptoms c) Negative alterations in mood and cognitions (dysphoric type) d) alterations in arousal and reactivity. Proposed Diagnostic Criteria for Posttraumatic. Exposure to the trauma through electronic media, television, movies, and pictures is not considered as PTSD unless these traumatic events are work-related. PTSD patients can be the actual victim or witness. The definition of trauma in PTSD indicates ‘’Exposure to actual or threatened death, serious injury, or sexual violence.’’ Sexual assault is specifically included. DSM-5 draws a clear line about the traumatic event. The DSM-5 aimed to expand the definition of PTSD beyond the fear construct. The patient must have PTSD symptoms that persist for at least 1 month after the traumatic event. DSM-5 eliminates the distinction between acute and chronic phases of PTSD. Trauma- and Stress¬or-Related Disorders reşect the close relationship between anxiety disorders, obsessive-compulsive and dissociative disorders. The Trauma-and-Stressor Related Disorders include Reactive Attachment Disorder, Disinhibited Social Engagement Disorder, Acute Stress Disorder, PTSD and Adjustment Disorders. In DSM-5, Posttraumatic Stress Disorder (PTSD) is no longer included in Anxiety Disorders and included in a new chapter as Trauma- and Stress¬or-Related Disorders. DSM-5, The Diagnostic and Statistical Manual of Mental Disorders, was released at the American Psychiatric Association’s (APA) meeting in May 2013 that is the fifth major revision.
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