Posttraumatic Stress Disorder: Epidemiology, Diagnosis and Risk Factors

There is increasing awareness of the prevalence of posttraumatic stress disorder (PTSD) and the importance of early diagnosis and treatment. PTSD can be triggered by a single traumatic event (sexual assault, motor vehicle accident) or an accumulation of traumatic events (e.g., first responders). The diagnosis and treatment of PTSD can be complex due to biopsychosocial factors and due to the interplay between pre-traumatic, traumatic, and post-traumatic factors.

• Discuss the DSM-5 criteria for Posttraumatic Stress Disorder
• Discuss the risk and resilience factors associated with PTSD
• Identify the comorbidities of PTSD and their impact on quality of life

Treatment of Posttraumatic Stress Disorder

Early diagnosis and treatment of PTSD can reduce disability and reduce suicide risk. Clinical practice guidelines recommend cognitive behavior therapy, and pharmacological treatments (SSRIs, SNRIs) for the treatment of PTSD. Novel treatments such as ketamine, and psychedelics, are being explored for their utility in treatment-resistant PTSD.

• Utilize the co-occurrence of mental disorders as a guide for choosing appropriate pharmacologic and psychotherapy in PTSD
• Discuss the treatment of PTSD using medications and psychotherapy
• Identify novel strategies of treating PTSD

Generalized Anxiety Disorder

Generalized anxiety disorder (GAD) is a common anxiety disorder that presents in primary care and specialty care clinics. GAD is highly comorbid with mental disorders and physical health conditions. Brief screening measures such as GAD-7 can be used to screen for GAD in primary care. After carefully ruling out physical causes of anxiety (e.g., hypothyroidism), several cognitive behavior therapy and pharmacological treatments are effective in treating GAD. A careful review of comorbid psychiatric illness or physical illness can facilitate the appropriate use of pharmacological treatments.

• Discuss the diagnostic criteria and epidemiology of GAD
• Discuss the treatment of GAD using psychotherapy
• Identify appropriate pharmacological treatment of GAD

Panic Disorder: Epidemiology, Diagnosis, and Treatment

Panic attacks and panic disorder are prevalent and associated with significant impact on the individual, family, and society. Panic attacks can occur in many mental health conditions and require careful diagnostic workup to rule out physical health causes. Treatment of panic disorder requires pharmacological and psychotherapeutic techniques.

• Discuss the diagnostic criteria and epidemiology of panic disorder
• Identify the appropriate pharmacological treatment of panic disorder
• Utilize psychological treatment of panic disorder

Suicide Risk Assessment Using a Biopsychosocial Framework

Suicidal ideation, plans, and attempts are prevalent in the general population. Although depression and borderline personality disorder are associated with suicidal behavior, recent evidence demonstrates that anxiety disorders, posttraumatic stress disorder, and substance use disorders are important comorbid risk factors. Suicide risk factors are conceptualized using a biopsychosocial cultural framework. Clinical assessment of suicide risk includes understanding the modifiable and non-modifiable risk factors for suicide prevention.

• Discuss the epidemiology of suicidal behavior
• Identify the biopsychosocial risk factors for suicidal behavior
• Perform a clinical assessment of suicide risk

CBTm Classes: Prevention and Treatment of Mood and Anxiety Disorders

Cognitive behavior therapy with mindfulness is a class-based, and self-directed online program that has demonstrated evidence in reducing waiting times, and improving patient outcomes. This program has also been utilized in diverse populations (physicians, public safety personnel) to improve resilience and reduce the risk of mental disorders.

• Discuss the rationale for the development of the CBTm class and online program
• Present evidence on the efficacy of the program in clinical samples
• Present evidence on the efficacy of the CBTm program as a prevention tool in high-risk populations