PSTD in remission? Diagnosis question.

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heyjack70

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Hypothetical case:

Patient has symptoms of PTSD. You make the diagnosis and treat with meds. Patient has very good response, to the point of essentially no symptoms 4 months later. How do you diagnose the patient at this stage, when they are on meds and asymptomatic? The DSM-5 does not have remission specifiers for PTSD. Do you diagnose PTSD and explain in the formulation that they are treated? Do you say a history of PTSD currently on medications?

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Asymptomatic after meds only? I doubt. Subthreshold with meds I can believe, though. If truely asymptomatic then I would question the vailidy of the original PTSD diagnosis.

As far as documentation, I would simply say history of PTSD and note treatment
 
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Asymptomatic after meds only? I doubt. Subthreshold with meds I can believe, though. If truely asymptomatic then I would question the vailidy of the original PTSD diagnosis.

As far as documentation, I would simply say history of PTSD and note treatment

I agree, unlikely that meds led to PTSD disappearing, but that does not mean original diagnosis was not correct. (I would question the validity of the diagnosis of PTSD in general but that is another story) Rather people just get better, even without treatment and depending on how far out pt was from the traumatic event it seems most likely that this was the natural course of it and had little/nothing to do with treatment.
 
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I would buy that if the stressor was relatively recent. We expect most trauma reactions/symptoms to simply go away on there own within a couple months, but if they dont, then you are likley going to struggle with it until its "treated." Literature is pretty clear that once avoidance takes hold as method coping, that it will continue to drive most other PTSD symptoms. In other words, unlike depression, we know this just doesnt "go away" over time once its been present for over 18 months (or something like that, dont quote me on the 18 months thing cause I cant remember the study)
 
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