Australian guidelines for the treatment of adults with acute stress disorder and post-traumatic stress disorder
Date
2007
Authors
Forbes, David
Creamer, Mark
Phelps, Andrea
Bryant, Richard
McFarlane, Alexander C
Devilly, Grant J
Matthews, Lynda
Raphael, Beverley
Doran, Christopher
Merlin, Tracey
Journal Title
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Volume Title
Publisher
SAGE Publications
Abstract
Over the past 2-3 years, clinical practice guidelines (CPGs) for post-traumatic stress disorder (PTSD) and acute stress disorder (ASD) have been developed in the USA and UK. There remained a need, however, for the development of Australian CPGs for the treatment of ASD and PTSD tailored to the national health-care context. Therefore, the Australian Centre for Posttraumatic Mental Health in collaboration with national trauma experts, has recently developed Australian CPGs for adults with ASD and PTSD, which have been endorsed by the National Health and Medical Research Council (NHMRC). In consultation with a multidisciplinary reference panel (MDP), research questions were determined and a systematic review of the evidence was then conducted to answer these questions (consistent with NHMRC procedures). On the basis of the evidence reviewed and in consultation with the MDP, a series of practice recommendations were developed. The practice recommendations that have been developed address a broad range of clinical questions. Key recommendations indicate the use of trauma-focused psychological therapy (cognitive behavioural therapy or eye movement desensitization and reprocessing in addition to in vivo exposure) as the most effective treatment for ASD and PTSD. Where medication is required for the treatment of PTSD in adults, selective serotonin re-uptake inhibitor antidepressants should be the first choice. Medication should not be used in preference to trauma-focused psychological therapy. In the immediate aftermath of trauma, practitioners should adopt a position of watchful waiting and provide psychological first aid. Structured interventions such as psychological debriefing, with a focus on recounting the traumatic event and ventilation of feelings, should not be offered on a routine basis.
Description
Keywords
Keywords: amitriptyline; antihypertensive agent; citalopram; fluoxetine; mirtazapine; mood stabilizer; nefazodone; neuroleptic agent; olanzapine; phenelzine; placebo; risperidone; serotonin uptake inhibitor; sertraline; acute stress disorder; agitation; Australia; ASD; Guidelines; PTSD; Trauma; Treatment
Citation
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Source
Australian and New Zealand Journal of Psychiatry
Type
Journal article
Book Title
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DOI
10.1080/00048670701449161
Restricted until
2037-12-31