Medicinski vjesnik, Vol. 25 No. (1-2), 1993.
Professional paper
Post-traumatic stress disorder (PTSD)
Nikola Mandić
Abstract
After a traumatic event outside usual human experience (floods, earthquakes, industrial disasters, fires, traffic accidents, death camps, tortures and bombardments), some people develop a disorder which was first defined in 1980. In the third edition of the Diagnostic and Statistical Manual (DSM-III) of mental diseases published by the American Psychiatric Association, a definition of post-traumatic stress disorder was established, complemented in the 1987 revision of the same edition and adopted in the International Classification of Dieseases and Causes of Death (ICD-10) in 1988. The disorder appears in 30-80% of the survivors of disasters, in 18-54% of war veterans, 17-67% of the prisoners and its prevalence is 9.2% during lifetime. The symptoms include revival of traumatic experience, avoidance of stimuli associated with the trauma, general numbness, decreased ability of reaction and excitability. The etiology of PTSD include: stressor (intensity, duration and circumstances of action), personality (age, personality traits, previous experience and psychic disturbances, genetic predisposition and available social support) and organic factors (effects of autononous nervous system and neurobiological changes of the brain). In order to better understand the etiology, there are psychoanlytical theories (primary and secondary gain, phobic neurosis and combat neurosis) and behavioral cognitive theories based on conditioning and learning theory. Clinical picture precedes subtle signs of fear and anxiety, functional and later structural physical responses in all the systems, from general vegetative excitability to biological alterations in the hypothalamo pituitari-adrenocortical axix, endogenic opiate system, daily rhythm of sleep, noradrenergic and serotoninergic functioning. Acute PTSD can disappear almost spontaneously within six months with an adequate psychosocial assistance, while the chronic form requires a treatment with psychotropic drugs, most frequently antidepressants, psychotherapy, from psychodynamically oriented techniques and hipnotherapy to behavioral cognitive procedures. The author uses current literature on PTSD and discusses diagnostics, etiology, clinical pictures, differential diagnosis, care and prognosis of the patients.
Keywords
PTSD; definition; etiology; clinical description; treatment; prognosis
Hrčak ID:
194273
URI
Publication date:
1.12.1993.
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