Basic approaches to the diagnosis and therapy of post-traumatic stress disorder

Vasileva, A. V.; Караваева, Татьяна; Lukoshkina, E P; Radionov, D. S.

doi:10.31363/2313-7053-2022-4-107-111

V.M. BEKHTEREV REVIEW OF PSYCHIATRY AND MEDICAL PSYCHOLOGY

2022

DOI: 10.31363/2313-7053-2022-4-107-111

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Basic approaches to the diagnosis and therapy of post-traumatic stress disorder

A. V. Vasileva

Татьяна Караваева

E P Lukoshkina³

et al.

Abstract: Based on a review of domestic and foreign literature, the article highlights the main approaches to the diagnosis and treatment of post-traumatic stress disorder (PTSD). The importance of rapid detection and timely provision of medical care for this disease is shown. The definition of PTSD is formulated, the etiological factors are described, the place in modern classifications, clinical features, the main groups of characteristic symptoms. The role of a medical psychologist in a multiprofessional team providi… Show more

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Cited by 5 publications

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Post-Traumatic Stress Disorder Psychotherapy - Integrating the Experience of an Emergency

Vasileva,

Karavaeva,

Radionov

2023

Консультативная Психология И Психотерапия

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Background. In domestic practice, there are still no clear ideas about effective approaches to psychotherapy, mechanisms of therapeutic effects, as well as principles and algorithms for providing assistance, despite the active development of the problems of PTSD and the presence of an evidence base for the effectiveness of therapy for this group of patients. Objective. The analysis of existing scientific publications on the use of psychotherapy in the treatment of PTSD and the definition of the basic principles and leading methods of psychotherapy used in helping people with PTSD, the formulation of algorithms for psychotherapeutic interventions and the content of the stages included in it. Materials and methods. Literature search was carried out on the databases PubMed, EMBASE, MEDLINE, RSCI and Cochrane Library. Preference was given to the works of the last 5 years. Results. The description of various techniques and techniques of psychotherapeutic interventions is given, the principles of choosing the tactics of psychotherapeutic treatment are considered. The features are noted and the main methods of psychotherapy used for the treatment of PTSD are described. The main mechanisms of the therapeutic effect are given. The methodology and structure of the therapeutic process, the principles of the stages of care and the description of the various stages of psychotherapeutic treatment are considered. Conclusions. Each of the methods of psychotherapy considered in the work has a large evidence base and is focused on trauma, causing a direct appeal to memories of a traumatic event or thoughts and feelings associated with a traumatic event.

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Post-Traumatic Stress Disorder Psychotherapy - Integrating the Experience of an Emergency

Vasileva,

Karavaeva,

Radionov

2023

Консультативная Психология И Психотерапия

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Post-traumatic stress disorder – from traumatic neurosis to ICD-11: features of diagnosis and selection of therapy

Vasileva

2023

Medicinskij sovet

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PTSD was determined as a stand-alone disorder about 50 years ago, and since then it is considered to be in the focus of attention of the mental health specialists. It’s main clinical features are the set of symptoms of re-experience of the traumatic event in here and now situation. They are defined to be the core symptoms for PTSD diagnostic. Clinical features and disorder course are the subject of wide prospective cohort studies with the use of the standardized psychometric instruments since the 80-s of the last century. In the new ICD-11 mental disorders classification, stress-associated disorders are defined as stand-alone rubric, the core PTSD symptoms are defined, the complex PTSD is proposed as a new diagnosis for the coding of persistent caused by prolonged psychotraumatic experience personality changes, the life-threatening diagnosis and intensive care unit experience were added to the list of PTSD triggers. The PTSD diagnosis is considered to be a challenging clinical task. The connection between symptoms manifestation and extreme traumatic experience should be established, one should take into consideration the existence of possible usually several weeks before symptoms manifestation latent period. It is useful to implement the recommended diagnostic instrument for the diagnosis verification and symptoms dynamic evaluation. The combination of pharmacotherapy and psychotherapy is recommended for PTSD treatment, individual approach should be used in case-management. In 2022 WFSBP Task Force on Treatment Guidelines for Anxiety, O and Post-Traumatic Stress Disorders have been published, there for the first-time cognitive behavior psychotherapy was determined as highly evidence based PTSD psychotherapeutic method of treatment. In March 2023 ministry of health of the Russian Federation has approved national PTSD clinical guidelines, where recommended medication list has been proposed taking into account the national clinical experience, in particular it includes a wide range of non-benzodiazepine anxiolytics. The article emphasizes the opportunities of their use and presents a clinical vignette where etifoxine is proposed as treatment of choice.

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Suicidal Behavior in the Context of Post-Traumatic Stress Disorder — Psychiatric and Psychosocial Aspects

Rozanov,

Karavaeva,

Vasileva

et al. 2024

Psychiatry

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Background: stress and trauma are important both for the development of PTSD and suicide, however, suicidal behavior in PTSD is not characterized enough. The aim of this narrative review is to present the latest and most evidence-based data on the relationship between suicidal behavior (in its wide range of manifestations — from suicidal thoughts and attempts to completedsuicide) with a psychiatric diagnosis of PTSD, or with individual symptoms of this disorder in different contingents. Materials and methods: data search was performed in PubMed and e-Library, as well as in relevant monographs, mostly evidence-based sources. Results: the data available strongly suggest that PTSD is not a priority, but a significant factor in an increased risk of suicide, especially in case of comorbidity with depression and addictions. The more a particular group is exposed to traumatic stress, the stronger the relationship between PTSD symptoms and suicidal behavior. The impact of PTSD on suicidality is largely mediated by the comorbidity and severity of psychosocial maladjustment that often accompanies PTSD. Dependence on a traumatic event and stress vulnerability are common links in the pathogenesis of PTSD, depression, and suicide. Conclusion: in clinical practice, the presence of a diagnosis or selected symptoms of PTSD is the reason for closer attention to the suicidal tendencies of the patient and the use of targeted prevention measures. On the population level, it is necessary to pay more attention to general hardiness and stress resilience.

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Basic approaches to the diagnosis and therapy of post-traumatic stress disorder

Cited by 5 publications

References 5 publications

Post-Traumatic Stress Disorder Psychotherapy - Integrating the Experience of an Emergency

Post-Traumatic Stress Disorder Psychotherapy - Integrating the Experience of an Emergency

Post-traumatic stress disorder – from traumatic neurosis to ICD-11: features of diagnosis and selection of therapy

Suicidal Behavior in the Context of Post-Traumatic Stress Disorder — Psychiatric and Psychosocial Aspects

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