icon showing 75 percent of peopleApproximately 75% of Americans have been exposed to a life-threatening trauma at some point during their lives.1 Responses to such trauma vary widely but may include withdrawal, anxiety, and the phenomenon known as posttraumatic stress disorder (PTSD), which is characterized by troubling feelings and thought processes lasting longer than 30 days.2 The types of trauma commonly associated with the development of PTSD include experiencing an actual or potential severe injury, life-threatening circumstance, physical or sexual assault, or other extreme social or natural event (such as a school shooting or tsunami). For PTSD to manifest, traumatic events that are outside of the individual’s normal realm of experience overwhelm his or her usual psychological defenses and are repeatedly experienced in distressing and intrusive ways in the individual’s mind.3

There are many symptoms of PTSD. Affected patients may experience flashbacks to the traumatic event, nightmares, restlessness, angry outbursts, negative thoughts about oneself or the world, loss of interest in enjoyable activities, and alienation and/or detachment from friends and family. Although these symptoms are common, the diagnosis of PTSD is relatively rare. Unfortunately, the diagnosis of PTSD may be perceived as a sign of weakness, especially in military or first responders. This perceived stigma and the lack of organizational support for PTSD sufferers have in turn been associated with an increased risk of PTSD symptom expression.4 For patients with PTSD, it’s like being trapped alone in a maze with seemingly no way out.

Knowing this, what can healthcare providers do to ensure that PTSD is diagnosed promptly and patients receive the treatment they need to find their way back to their lives? The recently published ACOEM Practice Guidelines on PTSD,5 which are available exclusively on MDGuidelines.com, provide evidence-based recommendations on screening tools and treatment options. According to the ACOEM guidelines, the provider should begin with a comprehensive history to define the trauma exposure and its severity, evaluate the patient’s mental and behavioral health, and determine the presence of any associated comorbidities. From there, screening tools, psychometric testing, and psychological inventories can assist the provider with making an accurate diagnosis. Once PTSD has been identified, a wide range of treatment options may be beneficial, including exercise and yoga, cognitive behavioral therapy, mind-body interventions, interpersonal therapy, meditation, and certain medications. These recommendations – along with their supporting evidence – are described in detail in the ACOEM Practice Guidelines. In addition, the ACOEM PTSD treatment algorithms provide a helpful overview of the diagnosis and treatment flow, guiding the user from the initial assessment of the traumatic event and continuing through to first- and second-line treatment options.5

PTSD is a complex phenomenon, with many theories on the condition proposed in the literature. It is not yet known why some individuals develop PTSD, while others who share the same experience do not.3 However, despite the complexities of PTSD, the prognosis for patients who receive timely treatment is good – the vast majority of these people recover to lead productive lives.5 Here at MDGuidelines, we’ll continue to monitor the literature for the latest evidence-based recommendations to help you guide your patients back to work safely and set them free to enjoy their favorite activities once again.

Information provided on this blog is intended for general educational use. It is not intended to provide medical advice. ReedGroup does not provide medical services. Consult a physician for medical advice on this or any other topic.

References

  1. Breslau N, Kessler RC. The stressor criterion in DSM-IV posttraumatic stress disorder: an empirical investigation. Biol Psychiatry 2001;50:699-704.
  2. Steinert C, Hofmann M, Leichsenring F, Kruse J. The course of PTSD in naturalistic long-term studies: high variability of outcomes. A systematic review. Nord J Psychiatry 2015;69:483-496.
  3. MDGuidelines®. Posttraumatic Stress Disorder. https://new.mdguidelines.com/mda/post-traumatic-stress-disorder
  4. Kelley CL, Britt TW, Adler AB, Bliese PD. Perceived organizational support, posttraumatic stress disorder symptoms, and stigma in soldiers returning from combat. Psychol Serv 2014;11: 229-234.
  5. Hegmann KT, et al., eds. ACOEM Posttraumatic Stress Disorder and Acute Stress Disorder Practice Guideline. Reed Group, Ltd., MDGuidelines®https://new.mdguidelines.com/acoem/disorders/workplace-mental-health/ptsd