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Occupation-induced posttraumatic stress disorders.

R S Schottenfeld, M R Cullen

    The American Journal of Psychiatry
    |February 1, 1985
    PubMed
    Summary
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    A variant of posttraumatic stress disorder (PTSD) can manifest as a somatoform disorder. Specific occupational exposures and personality traits may contribute to developing this atypical PTSD presentation.

    Area of Science:

    • Psychiatry and Psychology
    • Occupational Health
    • Toxicology

    Background:

    • Medically unexplained symptoms following toxic exposure can be disabling.
    • Distinguishing between somatoform disorders and posttraumatic stress disorder (PTSD) is clinically significant.
    • The presentation of PTSD can be atypical, mimicking other psychiatric conditions.

    Observation:

    • Twenty-one patients with severe, medically unexplained symptoms after occupational toxic exposure were assessed.
    • Diagnostic criteria were applied to differentiate between somatoform disorders and PTSD.
    • A significant subset of patients presented with atypical PTSD, distinct from typical PTSD and somatoform disorders.

    Findings:

    • Seven out of 21 patients (33%) were diagnosed with atypical posttraumatic stress disorder (PTSD).

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  • Three patients (14%) had typical PTSD, while the remaining 11 (52%) had somatoform disorders.
  • Specific occupational exposure factors and patient personality characteristics were identified as predictors for atypical PTSD.
  • Implications:

    • Recognizing atypical PTSD is crucial for accurate diagnosis and effective treatment planning.
    • This diagnosis offers theoretical, clinical, and therapeutic advantages over solely classifying symptoms as somatoform disorders.
    • Understanding contributing factors can inform preventative strategies in occupational health settings.