Skip to main content
Erschienen in: Current Psychiatry Reports 7/2016

01.07.2016 | Military Mental Health (CH Warner, Section Editor)

Treatment Options for Individuals with PTSD and Concurrent TBI: A Literature Review and Case Presentation

verfasst von: Hans R. Watson, Musammar Ghani, Terry Correll

Erschienen in: Current Psychiatry Reports | Ausgabe 7/2016

Einloggen, um Zugang zu erhalten

Abstract

Posttraumatic stress disorder (PTSD) is a well-studied mental health condition with existing guidelines and algorithms for treatment of PTSD. Those guidelines, while acknowledging an increased complexity, fail to provide clear PTSD treatment guidelines when an individual has a concurrent traumatic brain injury (TBI) diagnosis. Therefore, a literature review along with an accompanying case presentation is presented to demonstrate the minimum necessary considerations for approaching treatment of this complex population. Treatment approaches must be lead by providers that have the expertise and training necessary to consider all facets of the patient and their potential options. The provider must consider the pathophysiology of PTSD and TBI and be capable of leading a team to identify the patient’s source(s) of dysfunction, current cognitive abilities, and potential indications for psychotropic medications and/or other types of therapeutic intervention.
Literatur
3.
Zurück zum Zitat Kaufman DM, Milstein MJ. Kaufman’s clinical neurology for psychiatrists. 7th ed. Traumatic Brain Injury. New York: Saunders Elsevier; 2015. p. 527–536. Kaufman DM, Milstein MJ. Kaufman’s clinical neurology for psychiatrists. 7th ed. Traumatic Brain Injury. New York: Saunders Elsevier; 2015. p. 527–536.
4.
Zurück zum Zitat Sadock BJ, Sadock VA, Ruiz P. Kaplan & Sadock’s synopsis of psychiatry, Trauma and stressor related disorders. 11th ed. New York: Wolters Kluwer; 2015. p. p. 437–450. Sadock BJ, Sadock VA, Ruiz P. Kaplan & Sadock’s synopsis of psychiatry, Trauma and stressor related disorders. 11th ed. New York: Wolters Kluwer; 2015. p. p. 437–450.
5.
Zurück zum Zitat Sadock BJ, Sadock VA, Ruiz P. Kaplan & Sadock’s synopsis of psychiatry, Neural sciences. 11th ed. New York: Wolters Kluwer; 2015. p. 1–92. Sadock BJ, Sadock VA, Ruiz P. Kaplan & Sadock’s synopsis of psychiatry, Neural sciences. 11th ed. New York: Wolters Kluwer; 2015. p. 1–92.
6.••
Zurück zum Zitat Welton R, Kay J. The neurobiology of psychotherapy. Psychiatric Times [Internet]. 2015 October [cited 2016 Feb 15]. Available from Psychiatric Times: http://www.psychiatrictimes.com/neurobiology-psychotherapy This study used neuroimaging to demonstrate that therapy restores frontal lobe functioning and brings the amygdala back into regulation. Thus demonstrating the mechanism of action found with the resolution of the neuroanatomic dysfunction found in PTSD. Welton R, Kay J. The neurobiology of psychotherapy. Psychiatric Times [Internet]. 2015 October [cited 2016 Feb 15]. Available from Psychiatric Times: http://​www.​psychiatrictimes​.​com/​neurobiology-psychotherapy This study used neuroimaging to demonstrate that therapy restores frontal lobe functioning and brings the amygdala back into regulation. Thus demonstrating the mechanism of action found with the resolution of the neuroanatomic dysfunction found in PTSD.
8.
Zurück zum Zitat Tasman A, Kay J, Lieberman JA, First MB, Maj M. Psychiatry. 3rd ed. In: Meaney MJ, LeDoux JE, Liebowitz ML. Neurobiology of anxiety disorders. West Sussex, England: Wiley-Blackwell; 2008 p. 317–338. Tasman A, Kay J, Lieberman JA, First MB, Maj M. Psychiatry. 3rd ed. In: Meaney MJ, LeDoux JE, Liebowitz ML. Neurobiology of anxiety disorders. West Sussex, England: Wiley-Blackwell; 2008 p. 317–338.
9.
Zurück zum Zitat Silver JM, McAllister TW, Yudofsky SC. Textbook of traumatic brain injury. 2nd ed. Arlington: American Psychiatric Publishing Inc; 2011. Silver JM, McAllister TW, Yudofsky SC. Textbook of traumatic brain injury. 2nd ed. Arlington: American Psychiatric Publishing Inc; 2011.
10.
Zurück zum Zitat Arciniegas DB, Zasler ND, Vanderploeg RD, Jaffee MS, Garcia TA. Management of adults with traumatic brain injury. 1st ed. Arlington: American Psychiatric Publishing Inc; 2013. Arciniegas DB, Zasler ND, Vanderploeg RD, Jaffee MS, Garcia TA. Management of adults with traumatic brain injury. 1st ed. Arlington: American Psychiatric Publishing Inc; 2013.
11.
Zurück zum Zitat Sadock BJ, Sadock VA, Ruiz P. Kaplan & Sadock’s synopsis of psychiatry. 11th ed. Examination and diagnosis of the psychiatric patient. New York: Wolters Kluwer; 2015. p. 192–289. Sadock BJ, Sadock VA, Ruiz P. Kaplan & Sadock’s synopsis of psychiatry. 11th ed. Examination and diagnosis of the psychiatric patient. New York: Wolters Kluwer; 2015. p. 192–289.
12.
Zurück zum Zitat Hetrick SE, Purcell R, Garner B, Parslow R. Combined pharmacotherapy and psychological therapies for post traumatic stress disorder (PTSD). The Cochrane Collaboration. 2010: issue 7. Hetrick SE, Purcell R, Garner B, Parslow R. Combined pharmacotherapy and psychological therapies for post traumatic stress disorder (PTSD). The Cochrane Collaboration. 2010: issue 7.
13.
Zurück zum Zitat Mintz D. Meaning and medication in the care of treatment-resistant patients. Am J Psychother. 2002;56(3):322–37.PubMed Mintz D. Meaning and medication in the care of treatment-resistant patients. Am J Psychother. 2002;56(3):322–37.PubMed
14.••
Zurück zum Zitat Hoskins M, Pearce J, Bethell A, Dankova L, Barbui C, Tol WA, et al. Pharmacotherapy for post-traumatic stress disorder: systematic review and meta-analysis. The British Journal of Psychiatry. 2015;206:93–100. This study demonstrates that certain SSRI medications have a small benefit to PTSD treatment.CrossRefPubMed Hoskins M, Pearce J, Bethell A, Dankova L, Barbui C, Tol WA, et al. Pharmacotherapy for post-traumatic stress disorder: systematic review and meta-analysis. The British Journal of Psychiatry. 2015;206:93–100. This study demonstrates that certain SSRI medications have a small benefit to PTSD treatment.CrossRefPubMed
15.••
17.•
Zurück zum Zitat Abrams TE, Lund BC, Bernardy NC, Friedman MJ. Aligning clinical practice to PTSD treatment guidelines: medication prescribing by provider type. Psychiatric Services [Internet]. 2013 Feb [cited 2016 Feb 15]; 64 (2):142–148. Available from Psychiatric Services: http://ps.psychiatryonline.org/doi/full/10.1176/appi.ps.201200217 This study demonstrates that in spite of literature supported contraindications to certain traditional treatment for PTSD, such as benzodiazapines, providers continue with traditional treatment modalities in spite of the contraindications. Abrams TE, Lund BC, Bernardy NC, Friedman MJ. Aligning clinical practice to PTSD treatment guidelines: medication prescribing by provider type. Psychiatric Services [Internet]. 2013 Feb [cited 2016 Feb 15]; 64 (2):142–148. Available from Psychiatric Services: http://​ps.​psychiatryonline​.​org/​doi/​full/​10.​1176/​appi.​ps.​201200217 This study demonstrates that in spite of literature supported contraindications to certain traditional treatment for PTSD, such as benzodiazapines, providers continue with traditional treatment modalities in spite of the contraindications.
18.••
Zurück zum Zitat Guina J, Rossetter SJ, DeRhodes BJ, Nahhas RW, Welton RS. Benzodiazepines for PTSD: a systematic review and meta-analysis. Journal of Psychiatric Practice. 2014 Jul. 21(4) 281–303. This study demonstrates that, though traditionally used, the long term harm associated with the use of benzodiazepines merits a contraindication. Guina J, Rossetter SJ, DeRhodes BJ, Nahhas RW, Welton RS. Benzodiazepines for PTSD: a systematic review and meta-analysis. Journal of Psychiatric Practice. 2014 Jul. 21(4) 281–303. This study demonstrates that, though traditionally used, the long term harm associated with the use of benzodiazepines merits a contraindication.
19.
Zurück zum Zitat Bisson JI, Roberts NP, Andrew M, Cooper R, Lewis C. Psychological therapies for chronic post-traumatic stress disorder (PTSD) in adults (Review). The Cochrane Collaboration. 2013: issue 12. Bisson JI, Roberts NP, Andrew M, Cooper R, Lewis C. Psychological therapies for chronic post-traumatic stress disorder (PTSD) in adults (Review). The Cochrane Collaboration. 2013: issue 12.
20.•
Zurück zum Zitat Levi O, Bar-Haim Y, Kreiss Y, Fruchter E. Cognitive-behavioural therapy and psychodynamic psychotherapy in the treatment of combat-related post-traumatic stress disorder: a comparative effectiveness study. Clinical Psychology and Psychotherapy [Internet]. 2015 Available from wiley online library: http://onlinelibrary.wiley.com/doi/10.1002/cpp.1969/abstract This study demonstrates that long term outcomes PTSD treatment are not dependent on therapy styles as multiple styles have similar long term outcomes. Levi O, Bar-Haim Y, Kreiss Y, Fruchter E. Cognitive-behavioural therapy and psychodynamic psychotherapy in the treatment of combat-related post-traumatic stress disorder: a comparative effectiveness study. Clinical Psychology and Psychotherapy [Internet]. 2015 Available from wiley online library: http://​onlinelibrary.​wiley.​com/​doi/​10.​1002/​cpp.​1969/​abstract This study demonstrates that long term outcomes PTSD treatment are not dependent on therapy styles as multiple styles have similar long term outcomes.
21.
Zurück zum Zitat Hoge CW, McGurk D, Thomas JL, Cox AL, Engel CC, Castro CA. Mild traumatic brain injury in U.S. soldiers returning from Iraq. N Engl J Med. 2008;358(5):453–63.CrossRefPubMed Hoge CW, McGurk D, Thomas JL, Cox AL, Engel CC, Castro CA. Mild traumatic brain injury in U.S. soldiers returning from Iraq. N Engl J Med. 2008;358(5):453–63.CrossRefPubMed
22.
Zurück zum Zitat Carlson KF, Kehle SM, Meis LA, Greer N, MacDonald R, Rutks I, et al. Prevalence, assessment, and treatment of mild traumatic brain injury and posttraumatic stress disorder: a systematic review of the evidence. J Head Trauma Rehabil. 2011;26(2):103–15.CrossRefPubMed Carlson KF, Kehle SM, Meis LA, Greer N, MacDonald R, Rutks I, et al. Prevalence, assessment, and treatment of mild traumatic brain injury and posttraumatic stress disorder: a systematic review of the evidence. J Head Trauma Rehabil. 2011;26(2):103–15.CrossRefPubMed
Metadaten
Titel
Treatment Options for Individuals with PTSD and Concurrent TBI: A Literature Review and Case Presentation
verfasst von
Hans R. Watson
Musammar Ghani
Terry Correll
Publikationsdatum
01.07.2016
Verlag
Springer US
Erschienen in
Current Psychiatry Reports / Ausgabe 7/2016
Print ISSN: 1523-3812
Elektronische ISSN: 1535-1645
DOI
https://doi.org/10.1007/s11920-016-0699-9

Weitere Artikel der Ausgabe 7/2016

Current Psychiatry Reports 7/2016 Zur Ausgabe

Sleep Disorders (P Gehrman, Section Editor)

Disturbed Sleep and Postpartum Depression

Schizophrenia and Other Psychotic Disorders (SJ Siegel, Section Editor)

Systematic Review of Clozapine Cardiotoxicity

Eating Disorders (C Grilo, Section Editor)

Hormonal Factors and Disturbances in Eating Disorders

Substance Use and Related Disorders (F Levin and E Dakwar, Section Editors)

New Directions in Medication-Facilitated Behavioral Treatment for Substance Use Disorders

Sexual Disorders (G Dwyer, Section Editor)

Juvenile Sex Offenders

Update Psychiatrie

Bestellen Sie unseren Fach-Newsletter und bleiben Sie gut informiert.