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Primary care presentations of Post Traumatic Stress Disorder (PTSD): A case series analysis

Primary care presentations of Post Traumatic Stress Disorder (PTSD): A case series analysis. Dr John M. Shephard. Background. Common in current op tempo Trauma exposure a major risk Shame, guilt & sorrow important. Background. Clinical signs often delayed Co-morbid conditions

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Primary care presentations of Post Traumatic Stress Disorder (PTSD): A case series analysis

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  1. Primary care presentations of Post Traumatic Stress Disorder (PTSD):A case series analysis Dr John M. Shephard

  2. Background • Common in current op tempo • Trauma exposure a major risk • Shame, guilt & sorrow important

  3. Background • Clinical signs often delayed • Co-morbid conditions • Considerable barriers to treatment • Huge psych-social impact

  4. Aim To examine: • Patterns of PTSD presentation • Facilitators and barriers to case identification

  5. Study population • ARA Infantry Bn • RBG role • High tempo • Op Anode • Op Catalyst • Op Astute • Op Deluge

  6. Study subjects • Current PTSD cases Rx at RAP • Oct 07 – Sep 08 • Confirmed by Psychiatrist • MEC downgrade

  7. Data collection • Consent • UMR review • Interview

  8. Results • 5 new cases • < 1% prevalence • Rank: PTE – WO2 • Deployments • Rwanda (1) • INTERFET (1) • IRAQ (2) • TL (1)

  9. Traumatic exposure • Civilian atrocities (3) • Combat actions (1) • Non-battle fatality (1)

  10. Presentation • Time to diagnosis: 5.2 yrs (mean) • On deployment: 3/5 • ETOH incidents: 3/5 • Initial care giver • MO 4/5 • Padre 1/5

  11. Barriers • Poor psycho-education • Trivialisation of exposure • Pride • Discrimination • Career progression

  12. Outcome • Medical discharge 3/5 • Remission 1/5 • Ongoing 1/5

  13. Limitations • Small numbers • Descriptive design

  14. Conclusions • Prevalence rates appear lower than expected • Considerable time delay to identification • ETOH and deployment were common “triggers” for diagnosis

  15. Conclusions • No cases were identified at RtAPS/POPS • PTSD often led to discharge • Numerous and sizeable barriers to help seeking exist

  16. QUESTIONS? Dr John M. SHEPHARD BMed, DTM&H, FRACGP, MPH john.shephard@defence.gov.au

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