Trauma And Stress Related Disorders PDF

PSYCHIATRY ` PSYCHIATRY!PATHOLOGY SEC TION III 581 Trauma and stress-related disorders Adjustment disorder Emotional or behavioral symptoms (eg, anxiety, outbursts) that occur within 3 months of an identi!able psychosoci...

PSYCHIATRY ` PSYCHIATRY!PATHOLOGY SEC TION III 581 Trauma and stress-related disorders Adjustment disorder Emotional or behavioral symptoms (eg, anxiety, outbursts) that occur within 3 months of an identi!able psychosocial stressor (eg, divorce, illness) lasting < 6 months once the stressor has ended. Symptoms do not meet criteria for another psychiatric illness. If symptoms persist > 6 months after stressor ends, reevaluate for other explanations (eg, MDD, GAD). Treatment: CBT is !rst line; antidepressants and anxiolytics may be considered. Post-traumatic stress Experiencing, witnessing, or discovering that a loved one has experienced a life-threatening disorder situation (eg, serious injury, sexual assault) Ž"persistent Hyperarousal, Avoidance of associated stimuli, intrusive Re-experiencing of the event (eg, nightmares, #ashbacks), changes in cognition or mood (eg, fear, horror, Distress) (having PTSD is HARD). Disturbance lasts >"1"month with signi!cant distress or impaired functioning. Treatment: CBT, SSRIs, and venlafaxine are !rst line. Prazosin can reduce nightmares. Acute stress disorder—lasts between 3 days and 1 month. Treatment: CBT; pharmacotherapy is usually not indicated. Diagnostic criteria by symptom duration SLEEP DISORDERS Narcolepsy CHILDHOOD DISORDERS Tic disorder Disruptive mood dysregulation ADHD Specific learning Oppositional defiant Selective mutism Separation anxiety ANXIETY DISORDERS Phobias Adjustment