年度基层党支部工作升级达标考核细则....pptVIP

Pharmacotherapy for post traumatic stress disorder. Cochrane Database Sys Rev 2006 Jan 25(1):CD002795 PTSD Treatment Debriefing immediately following trauma is NOT necessarily effective Cognitive-behavioral therapy, exposure Group therapy Medications – antidepressants, mood stabilizers, beta-blockers, clonidine, prazosin, gabapentin Prazosin Start at 1mg qhs X 3 nights then increased by 1mg q 3 nights until nightmares improve or patient develops postural hypotension. Some patients can gain benefit a 1mg and some need 10mgs! Functional neuroimaging in PTSD Increased amygdalar activation is seen in PTSD pts compared to controls Hypoactivation of the medial prefrontal cortex including the orbitofrontal cortex and anterior cingulate cortex (area implicated in affect regulation) Francati V. et al. Functional Neuroimaging Studies in Posttraumatic Stress Disorder:Review of Current methods and Findings. Depression and Anxiety 2007;24:202-218 Study found treatment of PTSD with paroxetine resulted in increased anterior cingulate cortex function Fani N. et al. Increased neural response to trauma scripts in posttraumatic stress disorder following paroxetine treatment: A pilot study. Neurosci Letters 2011;491:196-201 Acute Stress Disorder Similar exposure as in PTSD Presence of 9 of 5 categories of intrusion, negative mood, dissociation, avoidance, and arousal related to the trauma. Duration of disturbance is 3 days to 1 month after trauma Causes significant impairment Screening questions How ever experienced a panic attack? (Panic) Do you consider yourself a worrier? (GAD) Have you ever had anything happen that still haunts you? (PTSD) Do you get thoughts stuck in your head that really bother you or need to do things over and over like washing your hands, checking things or count? (OCD) When you are in a situation where people can observe you do you feel nervous and worry that they will judge you? (SAD) Treatment General treatment approaches Pharmacotherapy Antidepresssants