Journal of IMAB - Annual Proceeding (Scientific Papers)
Publisher: Peytchinski, Gospodin Iliev
ISSN:
1312 773X (Online)
Issue:
2015, vol. 21, issue 4
Subject Area:
Medicine
Pages: 987-990
DOI: 10.5272/jimab.2015214.987
Published online: 09 December 2015
J of IMAB 2015 Oct-Dec;21(4):987-990
DIAGNOSTIC CHALLENGES IN ASSESSING POST-TRAUMATIC STRESS DISORDER.
Mariana Arnaudova 1


, Ivan Aleksandrov1, Valery Stoyanov2, Veronika Ivanova1, Petar Y. Petrov1
1) Medical University, Varna, University hospital “St. Marina”, Varna, Bulgaria
2) Varna Free University “Chernorizets Hrabar”, Bulgaria.
ABSTRACT:
Post-traumatic stress disorder (PTSD) is one of those psychiatric disorders that are still away from our attention, understanding, assessment and proper management. What could be the reason as by its name and diagnostic criteria an etiological fact is specified, namely a specific traumatic event.
In our paper we aim to share and elicit some difficulties that we have met in consulting, diagnostic and management of people, who have suffered a traumatic event.
On the base of a review of current psychiatric classifications and ongoing discussions we briefly summarize and discuss important key points.
The definition of the event, associated with PTSD is different in DSM-III (introduced for the fist time in a classification of mental disorders), DSM-IV and ICD-10. DSM-IV is less restrictive and includes events that occur more frequently. In DSM-5, PTSD is placed in chapter “Trauma and Stressor-related disorders” and the accent is on the variable clinical characteristics of psychological distress. Emotional reactions to the traumatic event are no longer part of Criterion A. The clinical presentation varies and a number of intrusive psychological and physiological reactions of distress are described. Here comes a problem- the assessment of the trauma itself and the determination of the basic symptoms, when such an event happens. So, the skills to assess the trauma, to determine and competently attribute these symptoms to the specific event and cluster are of great importance.
We conclude that a number of risk and prognostic factors should be considered in the process of assessment, diagnosis and management.
Key words: post-traumatic stress disorder, classification, ICD, DSM,
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Please cite this article in PubMed Style or AMA (American Medical Association) Style:
Arnaudova M, Aleksandrov I, Valery Stoyanov V, Veronika Ivanova V, Petrov PY. Diagnostic challenges in assessing post-traumatic stress disorder. J of IMAB. 2015 Oct-Dec;21(4):987-990. doi: http://dx.doi.org/10.5272/jimab.2015214.987
Correspondence to: Mariana Arnaudova-Jekova, MD, PhD, Third Psychiatric Clinic, MHAT “St. Marina”; 1, Hristo Smirnenski str, 9010 Varna, Bulgaria; E-mail: marnaudova@hotmail.com
REFERENCES:
1. Okoliyski M, Zarkov Z, Broshtilov A, Hinkov H, Nakov, V, Dinolova R, et al. National Representative Epidemiological Study of Common Psychiatric Disorders in Bulgaria (2003-2007): Twelve-month and lifetime prevalence, severity and co-morbidity. Bulgarian Journal of Public Health. 2010 Apr-Jun;2(2):2-13.
2. American Psychiatric Association. Diagnostic and statistical manual of mental disorders, (3rd ed.). Washington, DC, 1980.
3. Shalev A. Post-traumatic stress disorder: diagnosis, history and life course. In: Nutt D, Davidson J, Zohar J eds, Post-traumatic stress disorder: diagnosis, management ant treatment (Martin Dunitz Ltd, 2000): 1-15.
4. Brewin CR. Re-experiencing traumatic events in PTSD: new avenues in research on intrusive memories and flashbacks. Eur J Psychotraumatol. 2015 May 19;6:27180. [PubMed] [CrossRef]
5. American Psychiatric Association. Diagnostic and statistical manual of mental disorders(4th ed., text rev.). Washington, DC, 2000.
6. World Health Organization. The ICD-10 classification of mental and behavioural disorders: Clinical descriptions and diagnostic guidelines. Geneva: World Health Organization, 1992.
7. Bryant RA, O’Donnell M, Creamer M, McFarlane AC, Silove D. Posttraumatic intrusive symptoms across psychiatric disorders. J Psychiatr Res. 2011 Jun;45(6):842-847. [PubMed] [CrossRef]
8. Brewin CR, Gregory JD, Lipton M, Burgess N. Intrusive images in psychological disorders: Characteristics, neural mechanisms, and treatment implications. Psychol Rev. 2010 Jan;117(1):210-232. [PubMed] [CrossRef]
9. American Psychiatric Association. Diagnostic and statistical manual of mental disorders, (5th ed.). Washington, DC, 2013.
10. Friedman MJ. PTSD History and Overview. National Center for PTSD (25. 03. 2014) [Internet]
11. Friedman MJ, Resick PA, Bryant RA, Brewin CR. Considering PTSD for DSM-5. Depress Anxiety. 2011 Sep;28(9):750-769. [PubMed] [CrossRef]
12. Maercker A, Perkonigg A. Applying an international perspective in defining PTSD and related disorders: Comment on Friedman (2013). J Trauma Stress. 2013 Oct;26(5):560-562. [PubMed] [CrossRef]
13. Herman JL. Complex PTSD: A syndrome in survivors of prolonged and repeated trauma. J Trauma Stress. 1992 Jul;5(3):377-391. [CrossRef]
14. Prigerson HG, Horowitz MJ, Jacobs SC, Parkes CM, Aslan M, Goodkin K, et al. Prolonged grief disorder: Psychometric validation of criteria proposed for DSM-V and ICD-11. PLoS Medicine. 2009 Aug;6(8):e1000121. [PubMed] [CrossRef]
15. Shear MK, Simon NM, Wall MM, Zisook S, Neimeyer RA, Duan N, et al. Complicated grief and related bereavement issues for DSM-5. Depress Anxiety. 2011 Feb;28(2):103-117. [PubMed] [CrossRef]
16. Strain JJ, Friedman MJ. Considering adjustment disorders as stress response syndromes for DSM-5. Depress Anxiety.2011 Sep;28(9):818-823. [PubMed] [CrossRef]
17. Lanius RA, Brand BL, Vermetten, Frewen PA, Spiegel D. The dissociative subtype of posttraumatic stress disorder: Rationale, clinical and neurobiological evidence, and implications. Depress Anxiety. 2012 Aug;29(8):701-708. [PubMed] [CrossRef]
18. Friedman MJ. Finalizing PTSD in DSM-5: Getting here from there and where to go next. J Trauma Stress. 2013 Oct;26(5):548-556. [PubMed] [CrossRef]
19. Brewin CR. I wouldn't start from here -An alternative perspective on PTSD from ICD-11: Comment on Friedman (2013). J Trauma Stress. 2013 Oct;26(5):557-559. doi: [PubMed] [CrossRef]
20. Kilpatrick D. The DSM-5 Got PTSD Right: Comment on Friedman (2013). J Trauma Stress. 2013 Oct;26(5):563-566. [PubMed] [CrossRef]
21. Brewin CR. Episodic memory, perceptual memory, and their interaction: Foundations for a theory of posttraumatic stress disorder. Psychol Bull. 2014 Jan;140(1):69–97. [PubMed] [CrossRef]
22. Levin AP, Kleinman SB, Adler JS. DSM-5 and Posttraumatic Stress Disorder. J Am Acad Psychiatry Law. 2014;42(2):146–158. [PubMed].
Received: 14 September 2015
Published online: 09 December 2015
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