Premium
Treating adults with acute stress disorder and post‐traumatic stress disorder in general practice: a clinical update
Author(s) -
Forbes David,
Creamer Mark C,
Phelps Andrea J,
Couineau AnneLaure,
Cooper John A,
Bryant Richard A,
McFarlane Alexander C,
Devilly Grant J,
Matthews Lynda R,
Raphael Beverley
Publication year - 2007
Publication title -
medical journal of australia
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.904
H-Index - 131
eISSN - 1326-5377
pISSN - 0025-729X
DOI - 10.5694/j.1326-5377.2007.tb01158.x
Subject(s) - acute stress disorder , psychiatry , traumatic stress , medicine , distress , intervention (counseling) , mental health , tricyclic , clinical psychology , anxiety , psychology , pharmacology
General practitioners have an important role to play in helping patients after exposure to severe psychological trauma. In the immediate aftermath of trauma, GPs should offer “psychological first aid”, which includes monitoring of the patient's mental state, providing general emotional support and information, and encouraging the active use of social support networks, and self‐care strategies. Drug treatments should be avoided as a preventive intervention after traumatic exposure; they may be used cautiously in cases of extreme distress that persists. Adults with acute stress disorder (ASD) and post‐traumatic stress disorder (PTSD) should be provided with trauma‐focused cognitive behaviour therapy (CBT). Eye movement desensitisation and reprocessing (EMDR) in addition to in‐vivo exposure (confronting avoided situations, people or places in a graded and systematic manner) may also be provided for PTSD. Drug treatments should not normally replace trauma‐focused psychological therapy as a first‐line treatment for adults with PTSD. If medication is considered for treating PTSD in adults, selective serotonin reuptake inhibitor antidepressants are the first choice. Other new generation antidepressants and older tricyclic antidepressants should be considered as second‐line pharmacological options. Monoamine oxidase inhibitors may be considered by mental health specialists for use in people with treatment‐resistant symptoms.