PTSD diagnosis is not forever!

According to ICD-10, the post-traumatic stress disorder “appears as the delayed and prolonged response to a stressful event or situation … of exceptionally threatening or catastrophic nature, which, essentially, can cause a major distress almost in everyone.” Thus, two features of PTSD are emphasized: the pronounced psychogenic nature of the disorder and unconditional severity, which goes beyond the ordinary human experience, with exceptional strength of its pathogenic effects. In this regard, PTSD should be differentiated from the other psychogenic mental disorders, and secondly, it deserves a special attention particularly due to the severity of the trauma. PTSD diagnosis may include the following groups of clinical signs:

  1. A history of the traumatic event, which goes beyond the ordinary human experience, and serves as a traumatic (stressful) factor for most people.
  2. A constant re-experiencing of the traumatic event from the past. This criteria group includes four symptoms, and for the PTSD diagnosis it is sufficient to have at least one of them:
  • constant recurring intrusive memories, causing unpleasant emotional experience, connected with the trauma;
  • constant recurring dreams and nightmares, associated with traumatic event or events;
  • dissociative episodes (flashbacks) – sudden unexplained (like a stroke, or a thunderbolt) evocation of various aspects of the traumatic events (event);
  • outbursts of negative emotional manifestations, provoked by any event, associated with the circumstances, which led to the traumatic event.
  1. The sustainable desire to avoid anything or “block” anything that vaguely resembles of the trauma. According to this criterion, a PTSD diagnosis requires at least three of the seven symptoms:
  • the desire to avoid any thoughts and feelings, associated with the traumatic event;
  • trying to avoid any form of activity or situations, that arouse recollections of the traumatic event;
  • inability to reproduce the important elements of the traumatic situation (circumscribed amnesia);
  • the apparent loss of any interest to the forms of physical activity, which had a great importance before the trauma;
  • feelings of alienation and isolation from others;
  • the reduction of the positive affective responds (emotional blocking, inability to fully experience the feeling of joy or love, a sense of insecurity of the future – the inability to make a career, get married, have children and live together).
  1. Persistent symptoms, reflecting the excessive emotional excitement, which appeared after the trauma. For the PTSD diagnosis there have to be at least two of the six symptoms:
  • sleep disturbances;
  • increased irritability or outbursts of anger;
  • difficulties in concentrating;
  • excessive awareness;
  • increased fear susceptibility;
  • significant physiological changes, reminding the stressful experience.
  1. Time-based criterion – a time, during which the patient was observing the manifestations of the above symptoms, must be at least a month. Only this way one can speak of PTSD diagnosis. PTSD attacks developing after 6 months or more after the trauma are classified as specifically delayed responds. These criteria are successfully used in the PTSD diagnosis, but the critical analysis and proof of their reliability still continues.

The real clinical picture of PTSD, naturally, is much richer. One of the most important aspects is that, in spite of the severe suffering, patients rarely seek help on their own. This means, that the majority of patients are left without care they need, thus it is important to resolve all the organizational issues of the medical assistance.