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Posttraumatisk stresslidelse (PTSD)

Sist oppdatert: Sist revidert:
Sist revidert av:

Definisjon:
Er en relativt langvarig og ikke sjelden kronisk tilstand som kan oppstå etter alvorlige eller langvarige psykiske traumer
Forekomst:
Ca 1% av befolkningen lider til enhver tid av PTSD
Symptomer:
Vedvarende symptomer kan være påtrengende gjenopplevelser av hendelsen, unngåelse av stimuli som forbindes med hendelsen, vedvarende psykisk aktivering
Funn:
Kliniske funn er normale
Diagnostikk:
Ingen spesielle undersøkelser er påkrevet utover ev. standardiserte spørreskjema
Behandling:
De fleste behøver ikke behandling. Ulike psykologiske intervensjoner og antidepressiva har moderat effekt
  1. Warner CH, Warner CM, Appenzeller GN, Hoge CW. Identifying and managing posttraumatic stress disorder. Am Fam Physician. 2013 Dec 15;88(12):827-834. PubMed  
  2. American Psychiatric Association. Diagnostic and statistical manual of mental disorders, 5th edition, text revision. Washington, D.C.: American Psychiatric Association, 2013.
  3. Warner CH, Warner CM, Apenzeller GN, Hoge CW. Identifying and managing posttraumatic stress disorder. Am Fam Physician 2013; 88: 827-34. PMID: 24364547 PubMed  
  4. Bisson JI, Cosgrove S, Lewis C et al. Post-traumatic stress disorder. BMJ. 2015;351:h6161. PMID: 26611143 PubMed  
  5. Amstadter AB., Aggen SH., Knudsen GP et al. Potentially Traumatic Event Exposure, Posttraumatic Stress Disorder, and Axis I and II Comorbidity in a Population Based Study of Norwegian Young Adults. Soc Psychiatry Psychiatr Epidemiol 2013; 48: 215-23. PMID: 22782308 PubMed  
  6. Kessler RC, Rose S, Koenen KC et al. How well can post-traumatic stress disorder be predicted from pre-trauma risk factors? An exploratory study in the WHO World Mental Health Surveys.. World Psychiatry 2014; 13: 265-74. pmid:25273300 PubMed  
  7. Kringlen E. Posttraumatisk stressforstyrrelse. Tidsskr Nor Lægeforen 2007; 127: 61-2. PubMed  
  8. Kilpatrick DG, Koenen KC, Ruggiero KJ, et al. The serotonin transporter genotype and social support and moderation of posttraumatic stress disorder and depression in hurricane-exposed adults. Am J Psychiatry 2007; 164: 1693. pmid:17974934 PubMed  
  9. Roberts AL, Agnew-Blais JC, Spiegelman D et al. Posttraumatic stress disorder and incidence of type 2 diabetes mellitus in a sample of women: a 22-year longitudinal study.. JAMA Psychiatry 2015; 72: 203-10. pmid:25565410 PubMed  
  10. Holbrook TL, Galarneau MR, Dye JL, et al. Morphine use after combat injury in Iraq and post-traumatic stress disorder. N Engl J Med 2010; 362: 110-7. PMID: 20071700 PubMed  
  11. Dyregrov K. Umyndiggjør fagfolk sørgende og kriserammede?. Tidsskr Nor Lægeforen 2005; 125: 1853-5. PubMed  
  12. Smedsrud MK, Hem E, Ekeberg Ø. Psykologisk intervensjon etter traumer - gjør det vondt verre?. Tidsskr Nor Lægeforen 2005; 125: 1828-30. PubMed  
  13. Bisson JI, Roberts NP, Andrew M, Cooper R, Lewis C. Psychological therapies for chronic post-traumatic stress disorder (PTSD) in adults. Cochrane Database of Systematic Reviews 2013, Issue 12. Art. No.: CD003388. Cochrane (DOI)  
  14. Posttraumatic stress disorder: the management of PTSD in adults and children in primary and secondary care. NICE-guideline NG116. National Institute for Clinical Excellence (NICE), 2018 www.nice.org.uk  
  15. Jonas DE, Cusack K, Forneris CA, et al. Psychological and pharmacological treatments for adults with posttraumatic stress disorder (PTSD). AHRQ Comparative Effectiveness Reviews. Rockville (MD): Agency for Healthcare Research and Quality (US); 2013 Apr. Report No.: 13-EHC011-EF. PMID: 23658937 PubMed  
  16. Hetrick SE, Purcell R, Garner B, Parslow R. Combined pharmacotherapy and psychological therapies for post traumatic stress disorder (PTSD). Cochrane Database of Syst Rev 2010, Issue 7. Art. No.: CD007316. DOI: CD007316.pub2 Cochrane (DOI)  
  17. Fagermoen EM, Østensjø T, Skagemo CU, et al. Traumefokusert kognitiv atferdsterapi og komplekse traumer. Tidsskrift for Norsk psykologforening 2017; 55; 978-989. psykologtidsskriftet.no  
  18. Belsher BE, Beech E, Evatt D, Smolenski DJ, Shea MT, Otto JL, Rosen CS, Schnurr PP. Present‐centered therapy (PCT) for post‐traumatic stress disorder (PTSD) in adults. Cochrane Database of Systematic Reviews 2019, Issue 11. Art. No.: CD012898. DOI: 10.1002/14651858.CD012898.pub2. DOI  
  19. Zoellner LA, Roy-Byrne PP, Mavissakalian M, Feeny NC.. Doubly Randomized Preference Trial of Prolonged Exposure Versus Sertraline for Treatment of PTSD. Am J Psychiatry 2018. pmid:30336702 PubMed  
  20. Virtual reality i behandling av ångestsyndrom. SBU 2021 www.sbu.se  
  21. Polusny MA, Erbes CR, Thuras P, et al. Mindfulness-Based Stress Reduction for Posttraumatic Stress Disorder Among Veterans: A Randomized Clinical Trial. JAMA 2015; 314: 456-65. PMID: 26241597 PubMed  
  22. Williams T, Phillips NJ, Stein DJ, et al. Pharmacotherapy for post traumatic stress disorder (PTSD). Cochrane Database Syst Rev. 2022 Mar 2;3:CD002795. doi: 10.1002/14651858.CD002795.pub3 DOI  
  23. Jeffreys M, Capehart B, Friedman MJ. Pharmacotherapy for posttraumatic stress disorder: review with clinical applications. J Rehabil Res Dev 2012; 49: 703-15. pmid:23015581 PubMed  
  24. Kung S, Espinel Z, Lapid MI. Treatment of nightmares with prazosin: a systematic review. Mayo Clin Proc 2012; 87: 890-900. PubMed  
  25. Psykologiska, psykosociala och andra icke-farmakologiska insatser för att förebygga posttraumatiskt stressyndrom (PTSD) hos vuxna. SBU-rapport (2019-11-29) www.sbu.se  
  26. Läkemedel för att förebygga och behandla posttraumatiskt stressyndrom (PTSD) hos vuxna. SBU-rapport (2019-11-29) www.sbu.se  
  27. Rose SC, Bisson J, Churchill R, Wessely S. Psychological debriefing for preventing post traumatic stress disorder (PTSD). Cochrane Database of Systematic Reviews 2002, Issue 2. Art. No.: CD000560. DOI: CD000560 Cochrane (DOI)  
  28. Wessely S, Deahl M. Psychological debriefing is a waste of time: For/against. Br J Psychiatry 2003; 183: 12-4. PMID: 12835237 PubMed  
  29. Bradley R, Greene J, Russ E et al. A multidimensional meta-analysis of psychotherapy for PTSD. Am J Psychiatry 2005; 162: 214-27. PMID: 15677582 PubMed  
  30. Ekeberg Ø. Kriseintervensjon etter katastrofer. Tidsskr Nor Lægeforen 2005; 125: 714. PubMed  
  31. McNally RJ, Debunking myths about trauma and memory. Can J Psychiatry 2005; 50: 817-22 PubMed  
  32. Videbech P, Gerlach Øgard C, Sahl Andersen J. Posttraumatisk stresslidelse. Lægehåndbogen, sist oppdatert 06.01.2016.
  33. Gradus LJ, Qin P, Loncoln AK, et al. Posttraumatic stress disorder and completed suicide. Am J Epidemiol 2010; 171: 721-7. PMID: 20160171 PubMed  
  34. Amos T, Stein DJ, Ipser JC. Pharmacological interventions for preventing post-traumatic stress disorder (PTSD). Cochrane Database Syst Rev. 2014 Jul 8;7:CD006239. PMID: 25001071 PubMed  
  • Randolf Terje Vågen, medisinsk fagsjef, divisjon psykisk helsevern, St. Olavs hospital
  • Silje Folven Barlindhaug, spesialist i allmennmedisin, redaksjonsmedarbeider i NEL

Tidligere fagmedarbeidere

  • Olav Thorsen, spesialist allmennmedisin, Klubbgaten legesenter, Stavanger
  • Sten Thelander, överläkare, Farsta-Skarpnäck Psykiatriska Vårdenhet, Psykiatri Södra, Stockholm (Medibas)
  • K Gunnar Götestam, professor, Psykiatrisk institutt, Norges teknisk-naturvitenskapelige universitet, Trondheim