Última revisão: 31 Jun 2021
Última atualização: 30 Abr 2019

Resumo

Definição

História e exame físico

Principais fatores diagnósticos

  • exposição e resposta ao trauma
  • sintomas intrusivos
  • sintomas de evitação
  • alterações negativas nas cognições e humor
  • alterações no despertar e reatividade

Outros fatores diagnósticos

  • depressão
  • abuso de álcool ou de substâncias
  • ansiedade

Fatores de risco

  • acidente grave
  • testemunha de violência escolar ou doméstica
  • desastre natural
  • ataque terrorista
  • tortura
  • exposição a combate
  • lesão cerebral traumática
  • morte súbita de ente querido
  • ofensa grave
  • estupro
  • vitimização pelo atacante
  • trauma prévio
  • estressores múltiplos significativos na vida
  • apoio social baixo
  • história de transtorno mental
  • história de abuso de álcool e drogas
  • sexo feminino
  • idade mais jovem

Investigações diagnósticas

Primeiras investigações a serem solicitadas

  • Checklist do transtorno do estresse pós-traumático (TEPT; PTSD Checklist)
  • Checklist de TEPT para o DSM-5 (PCL-5)
  • Escala de Impacto de Eventos - Revisada (IES-R)
  • Escala de Trauma de Davidson (DTS)
  • Questionário de Rastreamento de Trauma (TSQ)
  • SPAN

Investigações a serem consideradas

  • Escala de TEPT Administrada pelo Clínico (CAPS)
  • Escala de TEPT Administrada pelo Clínico do DSM-5 (CAPS-5)
  • Entrevista Clínica Estruturada para os Transtornos do Eixo I do DSM-IV (Módulo SCID PTSD)
  • Versão de Entrevista da Escala de Sintomas de TEPT (PSS-I)

Algoritmo de tratamento

Colaboradores

Autores

Stanley Zammit, MA, BM BCh, MRCPsych, PhD

Professor of Psychiatric Epidemiology

Centre for Academic Mental Health

School of Social and Community Medicine

University of Bristol

Bristol

Clinical Senior Lecturer & Honorary Consultant Psychiatrist

Institute of Psychological Medicine and Clinical Neurosciences

Cardiff University

Cardiff

UK

Declarações

SZ declares that he has no competing interests.

Mathew Hoskins, MBBCh, MSc, MRCPsych

Consultant Psychiatrist and Clinical Teaching Fellow

Institute of Psychological Medicine and Clinical Neurosciences

School of Medicine

Cardiff University

Cardiff

Wales

Declarações

MH is an author of references cited in this topic.

Catrin Lewis, BSc, PhD

Research Associate

National Centre for Mental Health

Institute of Psychological Medicine and Clinical Neurosciences

School of Medicine

Cardiff University

Cardiff

Wales

Declarações

CL declares that she has no competing interests.

Agradecimentos

Dr Stanley Zammit, Dr Mathew Hoskins, and Dr Catrin Lewis would like to gratefully acknowledge Dr Neil P. Roberts, Dr Jonathan I. Bisson, and Dr Steve Wood, previous contributors to this topic.

Declarações

NPR is a member of the research team that developed a web-based guided self-help programme to treat PTSD. NPR has also received grant funding for research related to PTSD and undertaken systematic reviews, meta-analyses, randomised controlled trials, and other research in the traumatic stress field that may be referred to in this work. JIB and SW declare that they have no competing interests.

Revisores

Mort Rubinstein, MD

Deputy Associate Chief of Staff

Mental Health

VA New York Harbor Healthcare System

Clinical Associate Professor

New York University School of Medicine

New York

NY

Declarações

MR declares that he has no competing interests.

Neil Greenberg, MD, MRCPsych

Surgeon Commander

Royal Navy

Defence Professor of Mental Health, Visiting Professor of Psychiatry, and Co-Director

Academic Centre for Defence Mental Health

King's College London

London

UK

Declarações

NG has been principal investigator on studies with research funding greater than 6 figures USD. NG is a director of a company providing early intervention training for traumatic stress (the company does not provide PTSD treatment services).

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