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  Vol. 296 No. 5, August 2, 2006 TABLE OF CONTENTS
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Posttraumatic Stress Disorder

After people experience a very stressful event, they may feel that they should be able to move on and "just handle it" or "get over it." Some experiences, however, are so traumatic that people have serious problems coping and functioning in their daily lives afterward. They may have posttraumatic stress disorder (PTSD). The August 2, 2006, issue of JAMA includes articles about PTSD among adults and children affected by natural disasters. This Patient Page is based on one previously published in the August 1, 2001, issue of JAMA.

WHAT IS POSTTRAUMATIC STRESS DISORDER (PTSD)?

Posttraumatic stress disorder is the development of characteristic and persistent symptoms along with difficulty functioning after exposure to a life-threatening experience.


SYMPTOMS OF PTSD

  • Intrusion—memories of the trauma or "flashbacks" that occur unexpectedly; these may include nightmares or physical reactions such as a racing heart
  • Avoidance—avoiding people, places, thoughts, or activities that bring back memories of the trauma; this may involve feeling numb or emotionless, withdrawing from family and friends, or "self-medicating" by abusing alcohol or other drugs
  • Hyperarousal—feeling "on guard" or irritable, having sleep problems, having difficulty concentrating, feeling overly alert and being easily startled, having sudden outbursts of anger


WHO IS AT RISK FOR PTSD?

  • People with military combat experience or civilians who have been harmed by war
  • People who have been raped, sexually abused, or physically abused
  • People who have been involved in or who have witnessed a life-threatening event
  • People who have been involved in a natural disaster, such as a tornado or an earthquake


TREATING PTSD

  • Cognitive behavioral therapy with a trained psychiatrist, psychologist, or other professional can help change emotions, thoughts, and behaviors associated with PTSD and can facilitate managing panic, anger, and anxiety.
  • Certain medications can reduce symptoms such as anxiety, impulsivity, depression, and insomnia and decrease urges to use alcohol and other drugs.
  • Group therapy can help patients learn to communicate their feelings about the trauma and create a support network.
  • Becoming informed about PTSD and sharing information with family and friends can create understanding and support during recovery.


FOR MORE INFORMATION


INFORM YOURSELF

To find this and previous JAMA Patient Pages, go to the Patient Page Index on JAMA's Web site at http://www.jama.com.

Sources: American Psychiatric Association, Anxiety Disorders Association of America, National Center for Posttraumatic Stress Disorder, National Institute of Mental Health, Posttraumatic Stress Disorder Alliance, Sidran Foundation

The JAMA Patient Page is a public service of JAMA. The information and recommendations appearing on this page are appropriate in most instances, but they are not a substitute for medical diagnosis. For specific information concerning your personal medical condition, JAMA suggests that you consult your physician. This page may be photocopied noncommercially by physicians and other health care professionals to share with patients. To purchase bulk reprints, call 203/259-8724.

TOPIC: POSTTRAUMATIC STRESS DISORDER

Lise M. Stevens, MA, Writer; Cassio Lynm, MA, Illustrator; Richard M. Glass, MD, Editor

JAMA. 2006;296:614.


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Mental Health Problems Among Adults in Tsunami-Affected Areas in Southern Thailand
Frits van Griensven, M. L. Somchai Chakkraband, Warunee Thienkrua, Wachira Pengjuntr, Barbara Lopes Cardozo, Prawate Tantipiwatanaskul, Philip A. Mock, Suparat Ekassawin, Anchalee Varangrat, Carol Gotway, Miriam Sabin, Jordan W. Tappero, and for the Thailand Post-Tsunami Mental Health Study Group
JAMA. 2006;296(5):537-548.
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Symptoms of Posttraumatic Stress Disorder and Depression Among Children in Tsunami-Affected Areas in Southern Thailand
Warunee Thienkrua, Barbara Lopes Cardozo, M. L. Somchai Chakkraband, Thomas E. Guadamuz, Wachira Pengjuntr, Prawate Tantipiwatanaskul, Suchada Sakornsatian, Suparat Ekassawin, Benjaporn Panyayong, Anchalee Varangrat, Jordan W. Tappero, Merritt Schreiber, Frits van Griensven, and for the Thailand Post-Tsunami Mental Health Study Group
JAMA. 2006;296(5):549-559.
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