PTSD: The Daily PANCE Blueprint

PTSD: The Daily PANCE Blueprint

A 45-year-old male veteran presents to your clinic complaining of the following for 4 months: problems with concentration, difficulty staying asleep, persistent negative state, inability to remember events that happened while he was in Iraq, feelings of detachment from others, avoidance of other veterans, and distress when seeing violence on the TV. He denies hallucinations. He has been a veteran for 5 years. Which of the following is the most likely diagnosis?

A. Acute stress disorder
B. Cyclothymic disorder
C. Brief psychotic episode
D. Derealization/depersonalization disorder
E. Post-traumatic stress disorder

Answer and topic summary

The answer is E. Post-traumatic stress disorder

Post-traumatic stress disorder is a complex disorder defined by the behavioral, somatic, cognitive, and emotional effects of trauma. The most common causes are sexual relationship violence (33%), death or traumatic event of a loved one (30%), interpersonal violence like physical assault (12%), and participation in organized violence like combat (11%). The DSM-V criteria for PTSD is:

Exposure to a traumatic event(s). And then for ≥1 month of each of these that started/worsened after a traumatic event and are associated with the traumatic event:

1) Intrusion symptoms

2) Avoidance of stimuli

3) Alterations in cognitions and mood

4) Alterations in arousal/reactivity

Treatment is SSRIs + counseling/psychotherapy. About 50% of patients will recover in 3 months with treatment.

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Smarty PANCE Content Blueprint Review:

Covered under ⇒ PANCE Blueprint PsychiatryTrauma and stressor-related disordersPost-traumatic stress disorder

Also covered in Emergency Medicine EOR, and Family Medicine EOR Blueprint

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