Posttraumatic Stress Disorder

Stress Signs Often Missed in Victims of Violent Crime

By Leslie Sabbagh
Reported from the annual meeting of the Anxiety Disorders Association of America in Pittsburgh
The Medical Post, May 9, 1995

PITTSBURGH - There may be a silent epidemic of post traumatic stress disorder (PTSD) going undetected by primary care physicians.

According to research presented here by Drs. Dean Kilpatrick (PhD) and Sherry Falsetti (PhD), victims of violent crimes may suffer undiagnosed PTSD for many years, at great cost to their health and the healthcare system.

Primary care practitioners are under increasing pressure to assess, diagnose, treat and make appropriate referrals for patients who are heavy users of health-care services, said Dr. Kilpatrick, professor of clinical psychology and director of the National Crime Victims Research and Treatment Center at the Medical University of South Carolina. Some of these patients may be victims of crime, since they use health care more than nonvictims.

He outlined possible reasons for increased use of health-care resources following a violent assault, including:

"Violent crimes like rape, physical assault and homicide touch the lives of millions of Americans each year and produce persistent emotional effects, such as PTSD, which can last for many years.

"Understanding more about victims of violence and their problems has particular relevance for the primary care physician because victims are more likely to seek care from them than from mental health professionals," he said.

Drs. Kilpatrick and Falsetti said many crime victims also experience panic attacks.

Among 46 consecutive patients who sought treatment seekers at their crime victims centre in Charleston, S.C., 15 different traumatic events were reported, with more than 30 of the patients reporting more than one event.

"The most common diagnosis we found following traumatic events was PTSD; however, many individuals were also diagnosed with other comorbid disorders." said Dr. Kilpatrick. They also found 80% of patients coming in for treatment reported four or more physical reactions occurring at the same time, enough to diagnose a panic attack.

A majority (87%) also reported panic symptoms in the two weeks prior to their visit.

A large percentage of people who have experienced traumatic events and are seeking treatment for symptomatology related to those events experience a number of Panic symptoms as well as panic attacks, said Dr. Kilpatrick.

"Trauma histories of those seeking treatment for panic should be carefully assessed, and education about panic symptoms should be provided," he said.

Treatment should be geared to alleviating panic symptoms, and trauma-related treatment may be appropriate for those presenting with panic who have a victimization history.

Copyright 1995 Maclean Hunter Publishing Limited
Reprinted with permission.

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