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Post-traumatic stress disorder

What are the causes and symptoms of episodes of PTSD, and what are the possible treatments?

Definition of post-traumatic stress disorder (PTSD)

PTSD – definition

Post-traumatic stress disorder (PTSD) is a condition that can affect all of us. It is a disorder that can occur following the exposure to a traumatic event such as an accident, assault, attack, natural disaster or traumatic bereavement …
Symptoms can appear in the days following the traumatic event or several months or even years later.


Symptoms of post-traumatic stress disorder

There are several symptomatic phases :

  • the peritraumatic period from 0 to 48 hours after the event

  • the period of acute stress from 48 hours to 1 month after the event

  • beyond one month, we speak of post-traumatic stress disorder.

The specific symptoms of post-traumatic stress disorder are classified into three main categories :

  • a neurovegetative hyper-awakening with insomnia, hypervigilance with startle reactions and feeling of being on the “alert” permanently, irritability, anger or even concentration problems.

  • repetition syndrome with flashbacks, nightmares, intrusive thoughts related to the event and dissociative reactions.

  • avoidance of thoughts or situations that may recall the event.

People suffering from post-traumatic stress disorder may experience personality changes, dissociative amnesia (forgetting important personal memories) and cognitive distortions of fear (errors of thought fostering negative emotions).
PTSD is a disorder which can turn out to be very debilitating and give rise in a second stage, to the appearance of addictive behaviour, depressive symptoms and anxiety disorders (specific phobia, social phobia, panic disorder, etc.).

Post-traumatic stress disorder: the figures

According to the Institute for Public Health Surveillance, it is estimated that in 2004 in the United States, 5 to 6% of men and 10 to 14% of women suffered from PTSD. In Europe, 3% of the global population might be affected.
In France, the mental health survey conducted between 1999 and 2003 provided an estimate of the instantaneous prevalence of complete PTSD of 0.7%.
Prevalence can become very high in populations involved in catastrophic events and can affect 25 to 75% of direct victims, during the year following the event, and 5 to 40% of members of rescue teams intervened in traumatic action.
This high prevalence may persist long after the event. Thus, 12.4% of the members of the rescue teams working on the World Trade Center site and 15% of the survivors who evacuated the tower suffer from ESTP.
Road accident victims also represent a population at risk: of the 43,853 victims injured in 2010, between 23% and 35% are likely to develop PTSD between one and three months after the accident.

The causes of post-traumatic stress disorder

This problem can arise from potentially traumatic events such as an armed robbery, a road accident, a natural disaster, a (military) combat experience, or physical or sexual abuse.

Exposure to the traumatic event can be done in different ways:

The patient may have personally experienced the events. He or she may also have witnessed what happened to others. Trauma can also occur when the person learns what happened to a loved one (especially death).

Repeated or extreme exposure to details of an event can also lead to post-traumatic stress disorder (example: a police officer repeatedly exposed to child pornography).

PTSD can occur at any age, including childhood.

How to treat post-traumatic stress disorder?

PTSD can be treated on an outpatient basis or during a hospital stay. The treatment implemented must take into account the distance at which the patient is located in relation to the event causing the trauma.

The therapeutic choices will also depend on the most marked symptoms and the most painful for the patient.

Psychotherapy plays a major role as well as EMDR (Eye Movement Desensitization and Reprocessing) type of therapies,  which have shown their effectiveness in multiple studies around the world.

Social and administrative support carried out in parallel with medical support also represent a precious help for the patient.