Post-traumatic stress disorder (PTSD) treatment experience in Bedford East - audit and reaudit

Post-traumatic stress disorder (PTSD) can develop following exposure to a stressful event of an exceptionally threatening or catastrophic nature. Symptoms experienced by PTSD suffers can include re-experiencing the trauma through intrusive 'flashbacks' and recurrent dreams or nightmares, avoidance of stimuli associated with the stressor, hyperarousal, emotional blunting and an inability to remember aspects of the period of exposure to the stressor. We performed an audit of the treatment of PTSD in patients under the care of the Bedford East Mental Health Team to examine the psychological and pharmacological treatments currently being used and compared these with data collected in 2008. In summary, in the last 2 years there has been an increase in the identification of PTSD patients in Bedford East. These patients are a group with high levels of comorbidities and risk factors, and are challenging to treat. As a result of this, a wide range of agents including antidepressants with augementation, mood stabilizers and antipsychotic agents are used in their treatment, many of which are outside of NICE guidelines. There appears to be less availability of psychological therapy in these patients than we would expect. We discuss reasons for this and suggest possible solutions.