Naslov
Diagnoses and treatment of psychotic PTSP

Autori
Kozarić-Kovačić, Dragica ; Pivac, Nela

Vrsta, podvrsta i kategorija rada
Sažeci sa skupova, sažetak, znanstveni

Izvornik
Proceedings from Cambridge/Luton International Conference on Mental Health / Psychiatria Danubina 19(Suppl.1) / Hofmann, Gustav ; Sartorius, Norman - Zagreb : Medicinska naklada, 2007, 16-16

Skup
Cambridge/Luton International Conference on Mental Health

Mjesto i datum
Cambridge, Ujedinjeno Kraljevstvo, 11.10.2007. - 13.10.2007

Vrsta sudjelovanja
Predavanje

Vrsta recenzije
Međunarodna recenzija

Ključne riječi
psychosis ; war veterans ; therapy ; PTSD

Sažetak
The rate of comorbidity is especially high in combat-related PTSD and up to 80% of individuals with PTSD meet criteria for at least one of the psychiatric diagnosis. The most frequent diagnoses are: major depressive disorder, other anxiety disorders, substance abuse, somatization, personalitiy disorders, and dissocijative disorders. There are also atypical clinical pictures of PTSD, as well as the difference in clinical presentation of the symptoms. Up to 40% of combat veterans with PTSP may have comorbid psychotic symptoms or meet criteria for a comorbid psychotic disorder diagnosis. Many of these patients have hallutinations, paranoid ideation or disorganizd behaviour. PTSD with psychotic features may be a distinct subtype of the disorder. Since PTSD is classifeid as an anxiety disorder, the treatment of PTSD includes the use of selective serotonin reuptake inhibitors, tricyclic antideoressants, monoamine oxidase inhibitors, adrenergic and antianxiety agenst, mood stabilizers, etc. War veterans, resistant to antidepressants and other farmacotherapy with current and chronic PTSD, comorbid with psychotic symptoms, were treated with novel antipsychotics in three open label studies. First one was comparative 6-week study with olanzapine (N=28) or fluphenazine (N=27)in 5-10 mg/day dose range, once or twice dailiy. Second one was an open trial study of treatment with risperidone (2-4 mg/day) given as a monotherapy in 26 male war veterans during 6-weeks. Third one was a monotherapy with with quetiapine in a dose range (25-400 mg/daily, during 8-weeks in 53 male war veterans. Treatment of severe insomnia and nightmares in 34 PTSD war veterans with clozapine (50 mg /day) in the evening for 7 days showed significant reduction in the HAMD items for sleep disorders and the item D1 of Watsons scale for PTSD, CGI-S, PGI-S. Atypical antipsychotic given as a monotherapy, significantly reduced PTSD and psychotic symptoms, and showed beneficial effects in war veterans with treatment-resistant psychotic combat-related PTSD. Clozapine was shown to be efficient in veterans having PTSD with severe sleep disorders, and nightmares, due to its strong sedative and anxiolytic effect.

Izvorni jezik
Engleski

Znanstvena područja
Kliničke medicinske znanosti

POVEZANOST RADA