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Multimodal Management of Post-Traumatic Stress Disorder
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Amir Shabani   |
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Abstract: (244 Views) |
Introduction: Clinically, the most important disorder that occurs after exposure to trauma is post-traumatic stress disorder (PTSD). Apart from the symptomatology required for diagnosis, PTSD has various aspects that are necessary to be familiar with for diagnosis and treatment: 1) The diagnosis should be based on a “lifetime” assessment; 2) Comorbidity with other psychiatric disorders is a rule; 3) During the diagnostic evaluation, there are misleading features that are often part of the normal course of the disorder; such as refraining from the mention of traumas or their serious consequences, substance abuse, and exaggeration of symptoms; 4) The long-term cognitive adverse effects could be very debilitating and sometimes evoke dementia and require cognitive rehabilitation; 5) Behavioral manifestations and mood swings can evoke bipolar and higher than that borderline personality disorder; 6) The injury to family members in the long-term care of patients with treatment resistant problems requires attention and intervention; 7) Given the social consequences of exposure to trauma, sometimes there is a need for intervention to destigmatize; 8) Somniphobia, grief, moral injury, community reentry, and compensatory neurosis are other clinical aspects that need to be discussed; 9) the course of the disorder is unpredictable and sensitive to environmental changes. Therefore, long-term follow-up is needed for the assessment of treatment response. An important component of the treatment is psychotherapy methods; but in most cases, pharmacotherapy becomes necessary, and family and community support are often critical. Different types of psychotherapy, including prolonged exposure therapy (PE), cognitive restructuring, cognitive-behavioral therapy (CBT and CBT-I), cognitive processing therapy (CPT), metacognitive therapy (MCT), compassion-focused therapy (CFT), mindfulness-based cognitive therapy (MBCT), eye movement desensitization and reprocessing (EMDR), group therapy, dynamic psychotherapy, written exposure therapy (WET), and even drug-assisted psychotherapy have been studied and have obtained varying levels of evidence. Pharmacotherapy mainly consists of the medications that: 1) are effective in general manifestations and 2) target sleep disturbance as one of the main symptoms. In summary, the diagnosis of PTSD requires trauma screening to be included in the routine assessment; and the treatment needs a comprehensive look, awareness of existing intervention methods, and attention to social aspects.
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| Keywords: Trauma, Disaster, Post-traumatic stress disorder, Mental health |
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Full-Text [PDF 309 kb]
(35 Downloads)
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Type of Study: Research |
Subject:
General
Received: 2023/12/29 | Accepted: 2023/08/23 | Published: 2023/08/23
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