Nakell Linda
Family Practice Residency Program, Contra Costa Regional Medical Center, 2500 Alhambra Avenue, Martinez, CA 94553, USA.
Prim Care. 2007 Sep;34(3):593-610, vii. doi: 10.1016/j.pop.2007.05.010.
Trauma and post-traumatic stress disorder (PTSD) affect patients' physical health and daily functioning. Primary care physicians should remember to screen for trauma history and symptoms of PTSD when patients present with somatization, chronic pain, or other unexplained symptoms. Perceived loss of control, including physical examinations and procedures, may be frightening, and physicians should ask the patient's permission before touching them. Patients who have PTSD benefit from treatment, including both psychopharmacology (primarily selective serotonin reuptake inhibitors) and psychotherapy. Finally, hearing patients' stories of trauma and exposure to very sick patients can be traumatizing for physicians, who are encouraged to actively engage in self-care activities.
创伤和创伤后应激障碍（PTSD）会影响患者的身体健康和日常功能。当患者出现躯体化、慢性疼痛或其他不明原因的症状时，初级保健医生应记得筛查创伤史和PTSD症状。包括体格检查和医疗程序在内的感知到的失去控制可能会令人恐惧，医生在触碰患者之前应征得患者同意。患有PTSD的患者可从治疗中获益，包括心理药理学（主要是选择性5-羟色胺再摄取抑制剂）和心理治疗。最后，倾听患者的创伤经历以及接触重病患者的情况，对医生来说可能会造成创伤，鼓励医生积极参与自我护理活动。
