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| '''For patient information click [[Post traumatic stress disorder (patient information)|here]]''' | | '''For patient information click [[Post traumatic stress disorder (patient information)|here]]''' |
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| {{CMG}} | | {{CMG}}; {{AE}} {{KS}} |
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| {{SK}} PTSD | | {{SK}} PTSD |
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| | ==[[Post traumatic stress disorder overview|Overview]]== |
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| | ==[[Post traumatic stress disorder historical perspective|Historical Perspective]]== |
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| | ==[[Post traumatic stress disorder pathophysiology|Pathophysiology]]== |
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| | ==[[Post traumatic stress disorder causes|Causes]]== |
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| | ==[[Post traumatic stress disorder differential diagnosis|Differentiating Post Traumatic Stress Disorder from other Diseases]]== |
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| | ==[[Post traumatic stress disorder epidemiology and demographics|Epidemiology and Demographics]]== |
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| | ==[[Post traumatic stress disorder natural history, complications and prognosis|Natural History, Complications and Prognosis]]== |
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| ==Cultural aspects== | | ==Diagnosis== |
| ===Veterans and politics===
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| Early cases of the disorder were recognized after World War I, including individuals treated by [[Sigmund Freud]]. The diagnosis was removed from DSM-II, which resulted in the inability of Vietnam veterans to receive benefits for this condition. In part through the efforts of [[Chaim F. Shatan]], who coined the term '''post-Vietnam Syndrome''', the condition was added to the DSM-III as posttraumatic stress disorder.<ref>International Society for Traumatic Stress Studies http://www.istss.org/what/history2.cfm</ref>
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| In the United States, the provision of compensation to veterans for PTSD is under review by the [[Department of Veterans Affairs]] (VA). The review was begun in 2005 after the VA had noted a 30% increase in PTSD claims in recent years. The VA undertook the review because of budget concerns and apparent inconsistencies in the awarding of compensation by different rating offices.
| | [[Post traumatic stress disorder diagnostic criteria|Diagnostic Criteria]] |[[Post traumatic stress disorder history and symptoms| History and Symptoms]] | [[Post traumatic stress disorder physical examination | Physical Examination]] | [[Post traumatic stress disorder laboratory findings | Laboratory Findings]] | [[Post traumatic stress disorder CT|CT]] | [[Post traumatic stress disorder MRI|MRI]] | [[Post traumatic stress disorder other imaging findings|Other Imaging Findings]] | [[Post traumatic stress disorder other diagnostic studies|Other Diagnostic Studies]] |
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| This led to a backlash from veterans'-rights groups, and to some highly-publicized suicides by veterans who feared losing their benefits, which in some cases constituted their only income. In response, on November 10, 2005, the Secretary of Veterans Affairs announced that "the Department of Veterans Affairs (VA) will not review the files of 72,000 veterans currently receiving disability compensation for post-traumatic stress disorder..."<ref>[http://www1.va.gov/opa/pressrel/pressrelease.cfm?id=1042 United States Department of Veteran Affairs]</ref>
| | ==Treatment== |
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| The diagnosis of PTSD has been a subject of some controversy due to uncertainties in objectively diagnosing PTSD in those who may have been exposed to [[psychological trauma|trauma]], and due to this diagnosis' association with some [[incidence (epidemiology)|incidence]] of compensation-seeking behavior.<ref>[http://www.truthout.org/docs_2005/122705J.shtml]</ref> A psychiatry professor recounts an interview with a veteran who reported to a VA medical center after he had received a leaflet listing PTSD symptoms and encouraging affected veterans to apply for compensation. During the interview, the veteran complained to the psychiatrist of "survivor ''quilt''." Asked what that was, he replied, "I don't know, Doc, but I've got it bad." It transpired that the leaflet had misprinted "[[Survivor guilt|survivor ''guilt'']]" as "survivor ''quilt''," and the veteran had quoted that symptom in his campaign to win PTSD compensation.<ref>Lecture in the ''Audio-Digest Psychiatry'' series, before 2007; volume no., issue no. and speaker's name unavailable.</ref>
| | [[Post traumatic stress disorder medical therapy|Medical Therapy]] | [[Post traumatic stress disorder secondary prevention|Secondary Prevention]] | [[Post traumatic stress disorder cost-effectiveness of therapy|Cost-Effectiveness of Therapy]] | [[Post traumatic stress disorder future or investigational therapies|Future or Investigational Therapies]] |
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| The matter of [[malingering]] is addressed by Brunet ''et al.'',<ref name="Bunet">{{cite journal
| | ==Case Studies== |
| | last =Brunet
| | [[Post traumatic stress disorder case study one|Case #1]] |
| | first =Alain
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| | authorlink =
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| | coauthors =Akerib, Vivian; Birmes, Philippe
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| | title =Don't Throw Out the Baby With the Bathwater (PTSD Is Not Overdiagnosed)
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| | journal =Canadian Journal of Psychiatry
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| | volume =52
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| | issue =8
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| | pages =501-502
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| | publisher =
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| | location =
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| | date= 2007
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| | url =
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| | doi =
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| | accessdate =2007-11-01 }}</ref> who conclude that "All mental disorders are prone to malingering when there are secondary gains, and PTSD is no exception. However, in the case of PTSD, the reverse is also true": PTSD is often under-reported due to fear of associated [[stigma]], a fear that is particularly high among [[emergency service]] workers and [[military]] personnel, and in societies where the traumatic event (e.g., [[sexual assault]]) may be associated with stigma.
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| While PTSD-like symptoms have been recognized in combat veterans of many [[military conflict]]s, the modern understanding of PTSD dates from the 1980s. Reported cases of combat-related PTSD from [[Operation Enduring Freedom]] and [[Operation Iraqi Freedom]] are being compiled in ePluribus Media's [http://timelines.epluribusmedia.org/timelines/index.php?&mjre=PTSD&table_name=tl_ptsd&function=search&order=date&order_type=ASC PTSD Timeline].
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| ===Canadian Veterans===
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| [http://www.vac-acc.gc.ca/general Veterans Affairs Canada] (VAC) is a new program including rehabilitation, financial benefits, job placement, health benefits program, disability awards and family support.<ref>[http://www.vac-acc.gc.ca/clients/sub.cfm?source=Forces/nvc&CFID=9295860&CFTOKEN=39698927 VAC-ACC.GC.CA]</ref>
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| ===Law===
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| If an individual suffering from PTSD commits a crime, there may be uncertainty about whether the individual can be held responsible for that act. In extreme cases, the defense of [[automatism (case law)|automatism]], where the defendant was unable to control his actions, may be available. PTSD may produce an ''internal'' defect of reason within the meaning of the [[M'Naghten Rules]] (which defines the [[mental disorder defence]] in some [[criminal jurisdiction]]s). The difference is that whereas defenses that rely on automatism result in an acquittal, since no guilt can be assigned to a party unable to control their actions; insanity or mental disorder leaves the "offender" available for [[sentence (law)|sentencing]] by the court. In the event that a death has resulted, [[diminished responsibility]] may be available as an alternative to insanity. This defense reduces what would otherwise have been [[murder]] to [[manslaughter]]. In the specific instance of spousal abuse, this is often called [[battered woman defense|battered woman syndrome]] and, more generally, the [[abuse defense]] in the U.S.
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| ==Related Chapters==
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| * [[Acute stress reaction]]
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| * [[Anxiety Disorders Association of America]]
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| * [[Biological psychiatry]]
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| * [[Chemical imbalance theory]]
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| * [[Complex post-traumatic stress disorder]]
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| * [[Critical incident stress Management]]
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| * [[Dissociative disorders]]
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| * [[Dissociative identity disorder]]
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| * [[Edna B Foa]]
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| * [[Ego-state therapy]]
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| * [[EMDR]]
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| * [[Emotional dysregulation]]
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| * [[List of counseling topics]]
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| * [[Mental health]]
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| * [[Post-abduction syndrome]]
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| * [[Post-abortion syndrome]]
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| * [[Prolonged exposure therapy]]
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| * [[Psychogenic amnesia]]
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| * [[Psychoneuroimmunology]]
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| * [[Somatic Experiencing]]
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| * [[Survivor syndrome]]
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| * [[Trauma model of mental disorders]]
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| ==Further reading==
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| *''MDMA-Assisted Psychotherapy for the Treatment of Post-Traumatic Stress Disorder'' Chapter 8 in ''Psychedelic Medicine: New Evidence for Hallucinogens as Treatment''. Michael Winkelman and Thomas B. Roberts (editors) (2007) Westport, CT: Praeger/Greenwood.
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| *''Moving a Nation to Care: Post-Traumatic Stress Disorder and America's Returning Troops'', by Ilona Meagher, Introduction by Penny Coleman, Foreword by Robert Roerich, M.D.
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| *''A War of Nerves. Soldiers and psychiatrists 1914-1994'' by Ben Shephard. Jonathon Cape: London 2000. 475 pp. Written by UK historian and producer, presents as a well researched, easy to read book with ++ references. Traces history of PTSD as a diagnosis wrt war service, as a problem for many: sufferer, psychiatrists both military and non-military, strategists, war office and politicians etc in various countries using eg patient accounts, war office accounts from doctors and military/political figures.
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| {{Mental and behavioural disorders}} | | {{Mental and behavioural disorders}} |
| | {{WH}} |
| | {{WS}} |
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| [[cs:Posttraumatická stresová porucha]]
| | [[Category:Psychiatry]] |
| [[da:Posttraumatisk belastningsreaktion]]
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| [[de:Posttraumatische Belastungsstörung]]
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| [[es:Trastorno por estrés postraumático]]
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| [[fr:Trouble de stress post-traumatique]]
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| [[ko:외상후 스트레스 장애]]
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| [[hr:Posttraumatski stresni poremećaj]]
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| [[it:Disturbo post traumatico da stress]]
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| [[he:הפרעת דחק פוסט-טראומטית]]
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| [[lt:Potrauminio streso sindromas]]
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| [[nl:Posttraumatische stress-stoornis]]
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| [[ja:心的外傷後ストレス障害]]
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| [[no:Posttraumatisk stresslidelse]]
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| [[pl:Zespół stresu pourazowego]]
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| [[sv:Posttraumatiskt stressyndrom]]
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| [[zh:创伤后心理压力紧张综合症]]
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| ==References==
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| {{Reflist|2}}
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| [[Category:Primary care]] | |
| [[Category:Disease]] | | [[Category:Disease]] |
| [[Category:Abnormal psychology]] | | [[Category:Abnormal psychology]] |
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| [[Category:Psychological stress]] | | [[Category:Psychological stress]] |
| [[Category:Traumatology]] | | [[Category:Traumatology]] |
| [[Category:Psychiatry]]
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