Post-traumatic stress disorder

What is post-traumatic stress disorder (PTSD) in bipolar disorder?

The Diagnostic and Statistical Manual of Mental Disorders’ (DSM-5) criteria for a diagnosis of post-traumatic stress disorder (PTSD) includes having been exposed to a trauma via direct means (e.g. threats, experience, or witnessing), or indirect means (e.g. learning that a relative or close friend has been exposed to a trauma).

For a diagnosis of PTSD, symptoms must last for more than one month and create distress and functioning impairment such as an inability to work, go to school, or socialise. Symptoms include persistently re-experiencing the traumatic event via intrusive thoughts, nightmares, or flashbacks. These can be brought on with exposure to traumatic reminders and are associated with emotional distress. As a result, avoidance of trauma-related stimuli occurs. There is often an inability to recall key features of the trauma.

Other symptoms include negative thoughts and assumptions about oneself or the world, exaggerated blame of self or others for causing the trauma, negative affect, decreased interest in activities, feelings of isolation, irritability or aggression, risky or destructive behaviour, hypervigilance, heightened startle reaction, and difficulty concentrating and sleeping.

What is the evidence on PTSD in people with bipolar disorder?

Moderate quality evidence find the lifetime prevalence of PTSD in people with bipolar I or bipolar II disorder is around 17%. This represents a medium-sized increased risk of PTSD when compared to people without bipolar disorder.

Moderate to low quality evidence suggests cognitive behavioural therapy may be effective for improving PTSD symptoms in people with bipolar disorder.

October 2021

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Last updated at: 12:28 am, 20th October 2021
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