Advances In The Prevention Of Post-traumatic Stress Disorder

Post-traumatic stress disorder (PTSD) refers to the delayed and long-lasting mental disorder following the exposure to the life-threatening experience. The major clinical manifestations of PTSD include re-experiencing of traumatic event, persistent high alertness, persistent avoidance and selective amnesia of the traumatic experience. The prognosis of PTSD is stubborn, which seriously impacts psychological and social function of patients. Nowadays, the increasingly intense of modern society in competition, accidental incident grows day by day, PTSD occurrences submit obvious rising tendency. So the prevention and cure, especially prevention, become a significant topic.Objective: we reviewed the advances in early intervention following traumatic events and gave some clinical practice recommendations for psychology and drug prevention of PTSD.Method: we performed a literature search including major databases: Medline, CBM, PubMed, using the MeSH words"Stress Disorders, Post-Traumatic", Subheading words"drug prophylaxis","prevention and control","psychology"and"drug therapy". In addition, we limited: Published in the last 10 years,Humans, All Adult: 19+ years, and searched reference of previous practice guideline of PTSD ,systematic review and meta-analyses of PTSD prevention and control, random controlled studies of psychology and drug therapy outcomes for PTSD. Additionally, patients must have met diagnostic criteria for PTSD using DSM-IV criteria.Results: There are 78 literatures in accordance with the above criteria, including 17 practice guideline of PTSD, 25 systematic review and meta-analyses, 36 control random controlled clinical studies of PTSD.Conclusion:1. Early psychological interventions We do recommend all health and social care workers should offer practical, social and emotional support to those involved a traumatic event. We do not recommend that systematic, brief, single-session interventions focusing on the traumatic incident are provided to everyone who has experienced as routine practice. Trauma-focused cognitive–behavioural therapy should be offered to those with severe post-traumatic symptoms. Treatment should be regular and continuous (usually at least once a week) and should be delivered by the same person. The duration of the trauma-focused cognitive-behavioural therapy should normally be 8–12 sessions, but if the treatment starts in the first month after the event, fewer sessions (about 5) may be sufficient. When the trauma is discussed in the treatment session, longer sessions (for example, 90 min) are usually necessary.2. Early intervention drug treatments for PTSD Besides early psychological interventions,there are some reports on early intervention drug treatments for PTSD. For example: the pilot results suggest that propranolol may have a preventive effect on subsequent PTSD. There is evidence suggesting a difference favouring hydrocortisone over placebo on reducing the likelihood of intensive care unit patients having a PTSD and improving the quality of life. Recently consideration should also be given to the use of suitable antidepressants, such as selective serotonin reuptake inhibitors, at an early stage. For sufferers who are likely to develop PTSD, paroxetine may be appropriate for use. In a ward, drug treatments may probably help as an early intervention for the incidence and development of PTSD.