Post traumatic stress disorder symptoms in a psychiatric population not presenting with trauma: a preliminary study

Abstract

A Af fr ri ic ca an n J Jo ou ur rn na al l o of f P Ps sy yc ch hi ia at tr ry y • February 2008 5 51 1 Introduction Post Traumatic Stress Disorder (PTSD) is an anxiety disorder currently defined by the coexistence of three clusters of symptoms, persisting for one month in survivors of a serious traumatic event .These clusters are:• Intrusive cluster -Intrusions can take the form of repeated, unwanted and uncontrollable thoughts of the trauma, and can include nightmare and/or flashbacks.• Avoidant cluster -These symptoms consist of the person's attempt to reduce exposure to people or places that may elicit memories of the event (or intrusive symptoms). This also involves symptoms such as social withdrawal, emotional numbing and a sense of loss of pleasure.• There is a dearth of South African information on the prevalence of PTSD in a psychiatric population. The aim of this study was to determine the prevalence and comorbidity of PTSD in a psychiatric population, not presenting on the basis of trauma. Method: The study was cross sectional and conducted at a psychiatric outpatient clinic in the Durban Metropolitan area. The sample was obtained from patients seen at follow up over a period of twelve weeks. The researcher randomly selected prospective participants and at the end of their consultation the purpose of the study was explained and they were invited to participate. Demographic characteristics and diagnosis were recorded. Thereafter, the Zulu version of the Modified Posttraumatic Diagnostic Scale (MPDS) was administered and data collected. Results: The study demonstrated that 22% of subjects reported symptoms of PTSD where the primary presentation was not trauma related. Conclusion: A significant number of psychiatric patients presenting for non-trauma related psychopathology report symptoms of PTSD when specifically questioned. The findings suggest that such questioning may be overlooked when dealing with psychiatric patients who do not specifically present on the basis of trauma.

PTSD in mental health outpatient settings: highly prevalent and under-recognized

“…To our knowledge, this is the first study using a semi-structured interview to have found such a low detection rate for PTSD in psychiatric outpatients. Two studies using self-report screening instruments yielded detection rates comparable to ours: Howgego et al7 found that a PTSD diagnosis was found in the medical records of only one in 27 PTSD-positive patients (3.7%), while Mkize8 reported that none of the 18 PTSD-positive patients were diagnosed in their medical records.…”

“…In addition to these studies, four others4,5,7,8 have examined current PTSD prevalence in psychiatric outpatients, although they used self-report screening instruments rather than a semi-structured diagnostic interview. In these studies, the prevalence ranged from 7% in Norway5 to 46% in Sweden 4.…”

Posttraumatic Stress Disorder and Barriers to Care in Eastern Cape Province, South Africa

“…This normalization dynamic has been shown to be useful in early traumatic stress alleviation, but it may not be enough to prevent the disorder (De Villiers, ). Consequently, people may not view their symptoms as serious enough to warrant professional attention (Carey et al., ; Mkize, ).…”

Reported exposure to trauma among adult patients referred for psychological services at the Free State Psychiatric Complex, Bloemfontein

“…Other methods of assessment may include questionnaires such as the Traumatic Life Events Questionnaire (TLEQ) (Kubany et al, 2002), but these are not routinely used. Clinical practice, therefore, may potentially lead to the underdiagnosis of PTSD, and prevent appropriate management and assessment of outcomes (Mkize, 2008). Adequate screening for all forms of psychopathology, including PTSD, may be hindered by a high clinic workload, limitations placed on time for consultations, and working in a cross-cultural setting (Carey, Stein, ZunguDirwayi, & Seedat, 2003).…”