AS10-02 - E-consalting: war related PTSD and the enduring personality change after catastrophic experience

Abstract

Background and aims: This study was examination e-consalting by Telepsychiatry of war related Posttraumatic stress disorder(PTSD) and the Enduring personality change after catastrophic experiense (EPCACE). Methods: The author´s objective is to analize component of symptoms in PTSD and EPCACE. The subjects were 200 male psychiatric patients by Telepsychiatry and e-consulting with war related PTSD by videoconferencing via broadband ADSL by 2 Mbps. Posttraumatic stress syndrome-PTSS-10 scale, HAMD and 20-item Zung self-rating scale was used to assess state measures of symptom severity. The study tested the equivalence of the two forms of service (clinical psychiatric consultation "face to face" and telepsychiatry with interactive videoconferencing psychiatric services) delivery with Client Satisfaction Questionnaire (CSQ-8). Results: The symptoms of prolonged PTSS(posttraumatic stress syndrome) with duration between six moths and two years had been founded at 154 (77%) and 46 (23%) of patients had no PTSS: symptoms of depression had been found at 165 (82,5%) patients. The enduring personality exchange after catastrophic experiense (F62.0), had been found at 26(13%) patients (P< 0.01); symptoms of depression had been found at 66 (33%) patients after two years. Index of the CSQ-8 in groups Face to face 21.8±2.5(M±SD) and in telepsychiatric group 22.1±2.7(M±SD). Conclusions: Evolution of PTSD symptoms and continued examination and follow-up by Telepsychiatry service and e-consalting may be important in predicting the eventual development of depressive symptoms and precipitation of EPCACE(F62.0) enduring personality exchange after catastrophic experience in the war related PTSD. The results demonstrated equivalent levels of satisfaction in both face-to-face and telepsychiatry groups.

Trajne promjene ličnosti nakon katastrofičnog iskustva i posttraumatski stresni poremećaj

“…Probleme stvara upotreba američke klasifikacije DSM-IV koja ne razlikuje dvije dijagnostičke kategorije, već navodi samo jednu dijagnostičku kategoriju i za akutni PTSP i za hronični (F43.1) PTSP. Rezultati ranijih studija pokazuju kod 75% ispitanika verifikovane udružene poremećaje: depresiju, alkoholizam, bolesti zavisnosti, te psihotične reakcije i poremećaje ličnosti; kod 79,1% verifikovana su umanjenja opšte životne aktivnosti i radne sposobnosti, kod 8,3 % kraniocerebralne povrede su udružene sa PTSP, što rezultira potrebom za kompleksnijim sagledavanjem pogotovo u domenu forenzičke psihijatrije [4]. Hendin i sar.…”

“…Hendin i sar. [4] ispituju kod vijetnamskih ratnih veterana razne manifestacije koje ukazuju na posttraumatska stresna oboljenja (PTSD), te pored osjećanja krivice zbog preživljavanja i depresivnosti, naročito ističu i ukazuju na suicidalnost. Klaster simptoma i poremećaja , koji upućuju na visoki rizik od suicida osoba oboljelih od PTSP i TPL čine: depresivnost, anhedonija, disforičnost, gubitak vitalnih nagona, seksualni poremećaji, osjećaj bezvrijednosti, osjećaj bezizlaznosti, gubitak smisla za životom, osjećaj krivice, agresivnost, alijenacija i izolacija od prijatelja ili porodice, konfliktuoznost, egzistencijalna ugroženost, gubitak posla, maritalni sukobi [5].…”