A group of 4 teenagers while going for a trip met a car accident. Out of four, 3 people died on the spot. Surviving girl was admitted in an ICU for 3 months. After being discharged she often gets up in night and feels terrified. She says that she sees same events in her dreams. She is now afraid of the cars. The diagnosis is?
Correct Answer: Post traumatic stress disorder
Description: Ans. is 'd' i.e., Post traumatic stress disorder * Information in this question are:-1. Traumatic event involving death and injury (car accident)2. Re-experience of the event through Nightmares (gets up in night 8c feels terrified)3. Avoidance (afraid to sit in a car again)* Diagnosis is PTSD.Stressors for stress disorders* Stress disorders occur after an extreme traumatic events involving the threat of personal death or injury. They can arise from experiences in war, torture, natural catastroph (earthquake, volcano, floods), assault, rape, and serious accidents (e.g., in car) in burning building.* Symptoms of PTSD develop within 6 months of stressor, However 10% patients have delayed onset.Risk factors for Stress disorders1) Vulnerability factors: - Low education, Lower social class, female gender, low self esteem/neurotic traits, previous traumatic events (including childhood trauma), previous self or family history of psychiatric problems (mood/ anxiety disorders).2) Protective factors: - High IQ, higher social class, male gender, psychopathic traits, chance to view body of dead relative / friend.3) Biological factors: - Following systems are hyperactive in PTSD : -a) Noradrenergic systemb) Opioid systemc) Hypothalamic-pituitary-adrenal (HDA) axis* Recently, the role of Hippocampus in PTSD has received increased attention. Animal studies have shown that stress is associated with structural changes in the hippocampus, and studies of combat veterans with PTSD have revealed a lower average volume in the hippocampal region of the brain. Structural changes in the amygadala, an area of the brain associated with fear, have also been demonstrated.
Category:
Psychiatry
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