Abstract
OBJECTIVE: To educate family physicians about screening, diagnosis, and treatment of psychological disorders related to traumatic events. QUALITY OF EVIDENCE: PsycLIT, PsychINFO, PILOTS, and MEDLINE databases were searched from January 1985 to December 2000 using the terms "acute stress disorder," "posttraumatic stress disorder," "traumatic stress," "psychotherapy," "psychosocial treatment," "treatment," and "pharmacotherapy." Recommendations concerning treatment of acute stress disorder (ASD) and posttraumatic stress disorder (PTSD) are based on evidence from trials of the highest quality. Conclusions about assessment and diagnosis are based on the most recent epidemiologic studies, consensus, and expert opinion. MAIN MESSAGE: Very often, ASD and PTSD are underdiagnosed and undertreated. Family physicians are likely to see patients suffering from these disorders. Early screening in primary care is a function of active listening; warm, safe patient-physician relationships; and careful examination of difficulties related to traumatic events. Ideally, patients with either ASD or PTSD should be referred to a specialist. If a specialist is unavailable, family physicians can offer support and prescribe medication to address patients' symptoms. CONCLUSION: Family physicians can help identify and treat patients presenting with disorders related to traumatic events.
Full Text
The Full Text of this article is available as a PDF (166.9 KB).
Selected References
These references are in PubMed. This may not be the complete list of references from this article.
- Alarcón R. D., Glover S., Boyer W., Balon R. Proposing an algorithm for the pharmacological management of posttraumatic stress disorder. Ann Clin Psychiatry. 2000 Dec;12(4):239–246. doi: 10.1023/a:1009090611519. [DOI] [PubMed] [Google Scholar]
- Ballenger J. C., Davidson J. R., Lecrubier Y., Nutt D. J., Foa E. B., Kessler R. C., McFarlane A. C., Shalev A. Y. Consensus statement on posttraumatic stress disorder from the International Consensus Group on Depression and Anxiety. J Clin Psychiatry. 2000;61 (Suppl 5):60–66. [PubMed] [Google Scholar]
- Breslau N., Davis G. C., Andreski P., Peterson E. Traumatic events and posttraumatic stress disorder in an urban population of young adults. Arch Gen Psychiatry. 1991 Mar;48(3):216–222. doi: 10.1001/archpsyc.1991.01810270028003. [DOI] [PubMed] [Google Scholar]
- Davidson J. R. Biological therapies for posttraumatic stress disorder: an overview. J Clin Psychiatry. 1997;58 (Suppl 9):29–32. [PubMed] [Google Scholar]
- Foa E. B., Meadows E. A. Psychosocial treatments for posttraumatic stress disorder: a critical review. Annu Rev Psychol. 1997;48:449–480. doi: 10.1146/annurev.psych.48.1.449. [DOI] [PubMed] [Google Scholar]
- Kessler R. C., Sonnega A., Bromet E., Hughes M., Nelson C. B. Posttraumatic stress disorder in the National Comorbidity Survey. Arch Gen Psychiatry. 1995 Dec;52(12):1048–1060. doi: 10.1001/archpsyc.1995.03950240066012. [DOI] [PubMed] [Google Scholar]