Posttraumatic stress disorder (PTSD) is one of the mental disorders for which we should screen all outpatients because it is:
1. Common
2. Can lead to significant consequences if left undiagnosed and untreated
3. Known to be frequently missed in clinical practice. It is important for us to actively screen for possible PTSD because patients with PTSD often don’t spontaneously tell clinicians about the traumatic event or the typical symptoms of PTSD.
Who should be screened for PTSD?
It has been recommended that screening for possible PTSD be done under the following conditions, in no particular order (Spoont et al., 2015):
– Survivors of disasters
– If there is a known history of exposure to a serious traumatic event
– If the patient’s clinical presentation is suggestive of PTSD
– All troops after deployment
– All veterans who use VA services
– Refugees
– Patients at inner-city clinics
– High-risk professions like firefighters and police officers.
Clinical recommendations
1. High-risk groups
Use the PCL-5, a 20-item questionnaire, to screen for possible/ probable PTSD.
2. All others
Step 1: Ask ONE question (from the questionnaire called PC-PTSD-5) that asks about a history of major trauma.
Step 2: If the person responds “Yes” to that one question, proceed and ask them all five questions about PTSD symptoms from the PC-PTSD-5 questionnaire.
For more on this, please see the following article on this website:
How to screen for PTSD using the PC-PTSD-5 questionnaire
Related Pages
Posttraumatic stress disorder (PTSD)—Clinical features
Four types of symptoms are present in PTSD
Not all trauma is associated with posttraumatic stress disorder (PTSD)
What is nightmare disorder and why is it important?
Posttraumatic stress disorder (PTSD)—Screening
Screen patients for a history of major trauma and, if present, for PTSD
How to screen for PTSD using the PC-PTSD-5 questionnaire
Posttraumatic stress disorder (PTSD)—Treatment
PTSD-associated nightmares: Menu of treatment options
Does prazosin work for PTSD? If so, for which symptoms?
How exactly should we dose prazosin in PTSD?
(Relative) contraindications to prazosin for PTSD-associated nightmares
Warning! Prazosin can lead to hypotension/ syncope after the first dose
These medications can be very problematic along with prazosin
Posttraumatic stress disorder (PTSD)—Other articles
Practice guidelines for posttraumatic stress disorder (PTSD)
What can we do to support “National Post-Traumatic Stress Disorder Awareness Month”?
References
Spoont MR, Williams JW Jr, Kehle-Forbes S, Nieuwsma JA, Mann-Wrobel MC, Gross R. Does This Patient Have Posttraumatic Stress Disorder?: Rational Clinical Examination Systematic Review. JAMA. 2015 Aug 4;314(5):501-10. doi: 10.1001/jama.2015.7877. Erratum in: JAMA. 2016 Jan 5;315(1):90. doi: 10.1001/jama.2015.16955. PMID: 26241601.
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