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  Vol. 292 No. 18, November 10, 2004 TABLE OF CONTENTS
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  Clinical Crossroads Update
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A 46-Year-Old Man With Anxiety and Nightmares After a Motor Vehicle Collision, 2 Years Later

Amy N. Ship, MD

JAMA. 2004;292:2262.

Since this article does not have an abstract, we have provided the first 150 words of the full text and any section headings.

In a Clinical Crossroads article published in September 2002, Murray Stein, MD, discussed a 46-year-old man with posttraumatic stress disorder (PTSD).1 The patient, Mr M, had physical and emotional symptoms resulting from his involvement in 3 motor vehicle collisions that occurred in the previous 2 years. In addition to persistent pain, he experienced insomnia, fear, difficulty concentrating, nightmares, profound fatigue, and diffuse anxiety.

Stein discussed the definition of PTSD and typical inciting events. He reviewed the risk factors for development of PTSD, the treatment options, and the prognosis. He noted that Mr M’s symptoms were beginning to improve several weeks after the most recent motor vehicle collision and suggested that therapy might help him address feelings of vulnerability and perhaps "protect" him from recurrence of PTSD symptoms, should he be exposed to another traumatic event.

We asked the patient to comment on his experiences since the . . . [Full Text of this Article]

MR M, THE PATIENT



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