P0361 - Psychiatric pathologies following major or minor trauma

Abstract

Posttraumatic stress disorder (PTSD) is a largely under-diagnosed condition probably because clinicians expect it only as a consequence of enormous (thus rare) trauma. Seemingly insignificant life events or incidents may cause typical PTSD or other severe pathologies with great impact on quality of life and mental health.

One such disabling condition, presenting as atypical PTSD, without flash-backs or nightmares and barely discernible restlessness, is ignored by textbooks or classifications and seldom recognized by health and invalidity insurance agencies.

Apparently minor traumatic events may also cause personality disorders, recurrent and resistant depression, phobias, General Anxiety Disorder, Obsessive Compulsive Disorder, dysthymia, somatoform disorder, manic episodes. There is no apparent connection between the objective importance of trauma and the severity of the resulting pathology.

Furthermore, the body itself stores the memory of trauma, and can thus produce various pathologies, sometimes of severe importance, such as backaches, headaches, muscular, joint, or even visceral disorders, whose basic cause is generally ignored. Therefore, post-traumatic physical conditions may generate significant medical expenses in diagnostic and therapeutic procedures, generally with disappointing results.

The economical implications of post-traumatic syndromes are enormous in terms of absenteeism, invalidity, medical and psychiatric expenses.

Since the treatment of psycho-trauma is most often salutary, it is imperative to recognize post-traumatic syndromes: clinicians should thus begin to consider this possibility, carefully detailed anamnesis of life events should be obtained, and subjective importance of traces left by each event investigated.

Significant case reports will be discussed.