Post-Traumatic Stress Disorder: Management at the Montfort Hospital
Authors: Kay-Anne Haykal, Issack Biyong
The post-traumatic stress disorder (PTSD) rises from exposure to a traumatic event and appears by a persistent experience of this event. Several psychiatric co-morbidities are associated with PTSD and include mood disorders, anxiety disorders, and substance abuse. The main objective was to compare the criteria for PTSD according to the literature to those used to diagnose a patient in a francophone hospital and to check the correspondence of these two criteria. 700 medical charts of admitted patients on the medicine or psychiatric unit at the Montfort Hospital were identified with the following diagnoses: major depressive disorder, bipolar disorder, anxiety disorder, substance abuse, and PTSD for the period of time between April 2005 and March 2006. Multiple demographic criteria were assembled. Also, for every chart analyzed, the PTSD criteria, according to the Manual of Mental Disorders (DSM) IV were found, identified, and grouped according to pre-established codes. An analysis using the receiver operating characteristic (ROC) method was elaborated for the study of data. A sample of 57 women and 50 men was studied. Age was varying between 18 and 88 years with a median age of 48. According to the PTSD criteria in the DSM IV, 12 patients should have the diagnosis of PTSD in opposition to only two identified in the medical charts. The ROC method establishes that with the combination of data from PTSD and depression, the sensitivity varies between 0,127 and 0,282, and the specificity varies between 0,889 and 0,917. Otherwise, if we examine the PTSD data alone, the sensibility jumps to 0.50, and the specificity varies between 0,781 and 0,895. This study confirms the presence of an underdiagnosed and treated PTSD that causes severe perturbations for the affected individual.
Keywords: Post-Traumatic Stress Disorder, diagnosis, co-morbidities, mental health disorders.Procedia APA BibTeX Chicago EndNote Harvard JSON MLA RIS XML ISO 690 PDF Downloads 848
 Van Der Kolk, B. Pelcovitz, D et al. Dissociation, somatization and effect dysregulation: The complexity of adaptation to trauma. Am J Psychiatry 1996; 153:83?
 American Psychiatric Association, Diagnostic and Statistical Manual of Mental Disorders (DSM IV), Fourth Edition, American Psychiatric Association, Washington, D.C., 1994.
 Davisdson JRT. Huges D. et al. Posttrauamtic stress disorder in the community: an epidemiological study. Psychol Med 1991; 21:1-19
 Cordova MJ. Andrykowski MA. et al. Frequency and correlates of postraumatic stress disorder like symptomes after treatment for breast cancer. J. Consult Clin Psychol 1995; 63:981-86
 Blanchartd EB. Cuckley TC. Et al. Posttrauamtic stress disorder and comorbid major depression: is the correlation an illusion? J anxiety Disord 1998; 12:21-37
 Ferrada-Noli M. Asberg M. Et al. Suicidal behaviour after severe trauma part 1: PTSD diagnoses, psychiatric comorbidity and assessments of suicidal behaviour. J Trauma Stress 1998; 11:543-62
 Rogers MP. Warshaw MG. et al. Comparing primary and secondary generalized anxiety disorder in a long-term naturalistic study of anxiety disorders. Depression & Anxiety. 1999; 10(1):1-7.
 Conn DK. Clarke D. Et al. Depression in holocaust survivors: profile and treatment outcome in a geriatric day hospital program. Int J of Geriatric Psychiatry 2000; 15(4):331-7.
 Mills KL. Teesson M. Et al. Trauma, PTSD, and substance use disorders: findings from the Australian national survey of mental health and well-being. Am J Psychiatry 2006; 163:651-58.
 Davidson JR. Hughes D. Et al. Posttraumatic stress disorder in the community: an epidemiological study. Psychol Med 1991; 21:713
 Jones MC. Dauphinais P. et al. Trauma-related symptomatology among American Indian adolescents. J of Traumatic Stress. 1997; 10(2):163-73.
 Perrin M. DiGrande L. Et al. Difference in PTSD prevalence and associated risk factors among world trade center disaster rescue and recovery workers. Am J Psychiatry 2007; 164-9.
 Vieweg WV. Julius DA et al. Posttraumatic stress disorder: clinical features, pathophysiology and treatment. Am J Med 2006; 163-77.
 Ayuso-Mateos, JL Global burden of post-traumatic stress disorder in the year 2000: version 1 estimates. Global burden of disease 2000.
 Kessler RD. Sonnega A. Et al. Posttraumatic stress disorder in the National comorbidity suvey. Arch Gen Psychiatry 1995; 52:1048
 Hoge CW. Castro CA. Et al. Combat duty in Iraq and Afghanistan, mental health problems and barriers to care. N Engl J Med 2004; 351-613
 Roth DL. Coles EM. Battered woman syndrome: a conceptual analysis of its status vis-a-vis DSM IV mental disorders. Medicine & Law. 1995; 14(7-8):641-58.
 Breslau N. Davis GC. Et al. Traumatic events and postraumatic stress disorder in an urban population of young adults. Arch Gen Psychiatry 1991; 48:216.
 Stein MB. Walker JR. Full and partial post-traumatic stress disorder: findings from a community survey. Am J Psychiatry 1997; 4:365-376.
 Faucet T. An introduction to ROC analysis. Pattern Recognition Letters 2006; 861-874.
 Helzer JE. Robins LN. Et al. Posttraumatic stress disorder in the general population: findings of the epidemiologic catchment area suvey. N Engl J Med 1987; 317:1630-34