Post-traumatic stress disorder (PTSD, "Vietnamese syndrome", "Afghan syndrome", etc.) is a serious mental condition that occurs as a result of a single or repeated psycho-traumatic situation , such as participation in hostilities , severe physical trauma , sexual violence or death threat [3] . With PTSD, a group of characteristic symptoms , such as psychopathological experiences , avoidance or loss of memory of traumatic events, and a high level of anxiety persist for more than a month after psychological trauma [3] .
| Post-traumatic stress disorder | |
|---|---|
| ICD-11 | 6B40 |
| ICD-10 | F 43.1 |
| ICD-10-KM | , , and |
| ICD-9 | 309.81 |
| ICD-9-KM | |
| Omim | |
| Diseasesdb | 33846 |
| Medlineplus | 000925 |
| eMedicine | med / 1900 |
| Mesh | D013313 |
Most people do not develop PTSD after traumatic events [4] .
Content
PTSD Reasons
Traumatic effects can be caused by military operations , natural and man-made disasters , terrorist acts (for example, hostage taking, violence , torture ), as well as prolonged and serious illnesses or the death of loved ones. In most cases, if the psychological trauma is severe, it causes an experience of intense fear , helplessness and extreme horror. .
Also traumatic are financial difficulties [5] , domestic violence , service in the “power structures”, where a person becomes a witness to serious crimes: PTSD is quite common among police, military (contract soldiers and conscripts), as well as children and women who have been abused at home, people who have experienced serious illnesses.
Clinical manifestations
The course of PTSD is manifested by repeated and intrusive reproduction in the mind of a traumatic event. At the same time, the stress experienced by the patient is often an extremely intense experience and sometimes even causes suicidal thoughts in order to stop the attack. Repeated nightmares and involuntary memories are also characteristic. At the same time, the patient strenuously avoids thoughts, feelings or conversations related to trauma, as well as actions, places or people that initiate these memories. Psychogenic amnesia is characteristic, the patient is not able to reproduce in memory a traumatic event in detail [3] . There is also overvigilance and a state of constant expectation of a threat . The condition is often complicated by somatic disorders and diseases - mainly from the nervous , cardiovascular , digestive and endocrine systems .
Trigger
A trigger is an event that causes an attack in a PTSD patient. Most often, the trigger is part of a traumatic experience - the crying of the child, the noise of the car, being on top, the image, the text, the telecast, etc. Patients with PTSD usually by all means avoid encounters with the trigger, trying to avoid a new attack.
Treatment
Treatment of PTSD is complex, at the beginning of the disease, medication and psychotherapeutic , after - predominantly psychotherapeutic. Practically all groups of psychotropic drugs can be used in PTSD therapy: tranquilizers , hypnotics , antidepressants , antipsychotics , in some cases anticonvulsants and psychostimulants . But the most effective antidepressants of the SSRI group, drugs that act on melatonin receptors, and tranquilizers [6] .
The effectiveness of cognitive psychotherapy in PTSD has been proven. So, when using cognitive therapy in women who experienced severe stress, clinical improvement was observed in 85% of patients and, in particular, was manifested by a significant decrease in indicators on the depression scale - even in those women who experienced stress in childhood [7] . In the framework of cognitive psychotherapy, the patient is taught techniques to reduce anxiety and get rid of repetitive images leading to distress ; a major role in cognitive therapy is also the identification and change of the value that the patient attaches to the traumatic event [8] .
Good results are obtained by the technique, during which the patient is taught at the time of the onset of the attack to concentrate on a vivid distracting memory, which over time forms the habit of automatically switching consciousness to neutral or positive emotions, bypassing the traumatic experience in the event of a trigger .
One of the psychotherapeutic methods of treating PTSD is the method of desensitization and processing by eye movement (DPDH) [9] . Numerous scientific studies prove the effectiveness of this method. According to meta-analyzes , DPDH is no less effective than the best of other existing treatments for PTSD, but it seems to be best tolerated and acts very quickly. When using DPDH, this method first causes the patient a traumatic memory with all its components - emotional, visual, cognitive and physical (body sensations) [10] - and then stimulates the information processing system that provides self-healing in psycho-traumatic situations, which previously failed recycle this painful trail [9] .
There is some preliminary evidence that psychedelic psychotherapy using MDMA or propranolol may be effective for patients who have not been helped by other types of treatment, but more research is needed [11] [12] .
Recent studies have shown the possibility of a beneficial effect in the treatment of PTSD by combining the memory reactivation method and playing Tetris . The applied method weakens the obsessive memories of participants whose memories were reactivated before playing Tetris. Subsequently, they were less concerned about obsessive memories compared with the control group [13] .
See also
- A look at two thousand yards
- Acute stress response
- Injury studies
- Coping
Notes
- ↑ Disease Ontology release 2019-05-13 - 2019-05-13 - 2019.
- ↑ Monarch Disease Ontology release 2018-06-29sonu - 2018-06-29 - 2018.
- ↑ 1 2 3 American Psychiatric Association. Diagnostic and Statistical Manual of Mental Disorders. - Fifth. - Arlington, VA: American Psychiatric Publishing, 2013 .-- P. 271-280. - ISBN 978-0-89042-555-8 . (DSM-V)
- ↑ National Collaborating Center for Mental Health (UK) Post-Traumatic Stress Disorder: The Management of PTSD in Adults and Children in Primary and Secondary Care . NICE Clinical Guidelines, No. 26 . Gaskell (Royal College of Psychiatrists) (2005). Date of treatment June 1, 2013.
- ↑ Money Troubles Trigger PTSD in Many (English) .
- ↑ Oleg Chaban “PSYCHOTHERAPY AT PTSD SHOULD BE DIRECTED TO CREATE A NEW COGNITIVE MODEL OF VITAL ACTIVITY ...” Journal of Neuro News: Psychoneurology and Neuropsychiatry No. 2 (21)
- ↑ Minutko V.L. Depression. - Moscow: GEOTAR-Media, 2006 .-- 320 p. - 2000 copies. - ISBN 5-9704-0205-2 .
- ↑ Beck J.C. Cognitive Therapy: A Complete Guide = Cognitive Therapy: Basics and Beyond. - M .: LLC “I.D. Williams " , 2006. - 400 p. - ISBN 5-8459-1053-6 .
- ↑ 1 2 Shapiro F. Psychotherapy of emotional injuries using eye movements: Basic principles, protocols and procedures / Per. from English A. S. Rigina. - M: Independent firm "Class", 1998. - (Library of Psychology and Psychotherapy). - ISBN 5-86375-102-9 .
- ↑ Servan-Schreiber, D. Antistress. How to overcome stress, anxiety and depression without drugs and psychoanalysis / D. Servan-Schreiber; [trans. from English E. A. Boldina]. - Moscow: RIPOL classic, 2013 .-- 352 p. - (New lifestyle). - ISBN 978-5-386-05096-2 .
- ↑ 3,4-Methylenedioxymethamphetamine's (MDMA's) Impact on Posttraumatic Stress Disorder // Annals of Pharmacotherapy: journal. - April 16, 2014.
- ↑ de Kleine RA, Rothbaum BO, van Minnen A. Pharmacological enhancement of exposure-based treatment in PTSD: a qualitative review // Eur J Psychotraumatology. - 17 Oct 2014. - Vol. 4.- DOI : 10.3402 / ejpt.v4i0.21626 . - PMID 24147208 . - PMC 3800126 .
- ↑ Whiteman O. Reactivation of memory and Tetris . 07/06/2015.
Literature
- in Russian
- Enikolopov S. N. Psychotherapy for psycho-traumatic stress disorders // Russian Psychiatric Journal . 1998, No. 3, p. 50-56.
- Injury: Points . Sat articles edited by S. Ushakina and E. Trubina. M.: New Literary Review , 2009.
- in other languages
- Caruth C. Unclaimed experience: trauma, narrative, and history. Baltimore: Johns Hopkins University Press 1996.
- Felman sh. The juridical unconscious: trials and traumas in the twentieth century. Cambridge: Harvard University Press , 2002.
- Luckhurst R. The trauma question. London New York: Routledge , 2008.