Ehlers Anke, Gene-Cos Nuri, Perrin Sean
King's College London, Institute of Psychiatry and Centre for Anxiety Disorders and Trauma, South London and Maudsley NHS Foundation Trust.
London J Prim Care (Abingdon). 2009;2(1):36-42.
Posttraumatic stress disorder (PTSD) is a common and disabling disorder that develops as a consequence of traumatic events and is characterised by distressing re-experiencing of parts of the trauma, avoidance of reminders, emotional numbing and hyperarousal. The NICE guidelines for PTSD (2005) recommend trauma-focused psychological therapy as the first-line treatment. A survey of 129 general practitioners in South London investigated the recognition and treatment of PTSD in primary care. The majority of GPs underestimated the prevalence of PTSD. Most PTSD patients seen in GP surgeries currently do not receive or are not referred for NICE recommended psychological treatments. Medications, especially SSRIs, appear to more commonly prescribed than recommended by NICE. Efforts to disseminate information about PTSD and effective treatments to both patients and GPs are needed to increase recognition rates and prompter access to treatment. The Improving Access to Psychological Therapies (IAPT) programme will make the NICE recommended treatments more widely available and will allow self-referral by adults with PTSD to trauma-focused psychological therapy.
创伤后应激障碍(PTSD)是一种常见且致残的疾病,它由创伤性事件引发,其特征包括对创伤部分的痛苦再体验、回避提示物、情感麻木和过度警觉。英国国家卫生与临床优化研究所(NICE)发布的PTSD指南(2005年)推荐以创伤为重点的心理治疗作为一线治疗方法。一项针对伦敦南部129名全科医生的调查研究了初级保健中PTSD的识别与治疗情况。大多数全科医生低估了PTSD的患病率。目前在全科医生诊所就诊的大多数PTSD患者没有接受或未被转介接受NICE推荐的心理治疗。药物治疗,尤其是选择性5-羟色胺再摄取抑制剂(SSRI),其处方量似乎比NICE推荐的更为常见。需要努力向患者和全科医生传播有关PTSD及有效治疗方法的信息,以提高识别率并促使患者更快获得治疗。改善心理治疗可及性(IAPT)计划将使NICE推荐的治疗方法更广泛地可得,并允许患有PTSD的成年人自行转介接受以创伤为重点的心理治疗。