1. American Psychiatric Association. Diagnostic and Statistical Manual of Mental Disorders, 4th ed. 1994. DSM-IV Diagnostic Criteria for PTSD Exposure to a traumatic event in which the person: –experienced, witnessed, or was confronted by death or serious injury to self or others AND –responded with intense fear, helplessness, or horror Symptoms –appear in 3 symptom clusters: re-experiencing, avoidance/numbing, hyperarousal –last for > 1 month –cause clinically significant distress or impairment in functioning

2. American Psychiatric Association. Diagnostic and Statistical Manual of Mental Disorders, 4th ed. 1994. DSM-IV Diagnostic Criteria for PTSD Re-experiencing Persistent re-experiencing of  1 of the following: –recurrent distressing recollections of event –recurrent distressing dreams of event –acting or feeling event was recurring –psychological distress at cues resembling event –physiological reactivity to cues resembling event

3. DSM-IV Diagnostic Criteria for PTSD Avoidance/Numbing Avoidance of stimuli and numbing of general responsiveness indicated by  3 of the following: –avoid thoughts, feelings, or conversations* –avoid activities, places, or people* –inability to recall part of trauma –  interest in activities –estrangement from others –restricted range of affect –sense of foreshortened future American Psychiatric Association. Diagnostic and Statistical Manual of Mental Disorders, 4th ed. 1994.

4. DSM-IV Diagnostic Criteria for PTSD Hyperarousal Persistent symptoms of increased arousal  2: –difficulty sleeping –irritability or outbursts of anger –difficulty concentrating –hypervigilance –exaggerated startle response American Psychiatric Association. Diagnostic and Statistical Manual of Mental Disorders, 4th ed. 1994.

5. Kessler R et al. J Clin Psychiatry. 2000;61(Suppl 5):4-14. Kessler R et al. Arch Gen Psychiatry. 1995;52:1048-1060. Prevalence of Trauma and Probability of PTSD Witness AccidentThreat w/ Weapon Physical Attack MolestationCombatRape 1 2 1 2

6. Lifetime Prevalence of PTSD in the Community 5% Lifetime Prevalence for Men 10.4% Lifetime Prevalence for Women Estimated Lifetime Prevalence of PTSD = 7.8% Kessler R et al. Arch Gen Psychiatry. 1995; 52:1048-1060.

7. Impaired Quality of Life with PTSD SF-36 = 36 item short form health survey Lower score = more impairment Malik M et al. J Trauma Stress. 1999;12:387-393. SF-36 Score

8. 1 Kessler R et al. J Clin Psychiatry. 2000; 61 (Suppl 5): 4-12. 2 Kessler R et al. Am J Psychiatry. 1999;156:115-123. Average work loss = 3.6 days/month 1 Annual productivity loss = $ 3 billion 1 Medical utilization: mean number of past year general medical visits 2 –PTSD5.3 –Any anxiety disorder4.4 –Major depression3.4 Economic Burden of PTSD

9. Agora phobia Comorbidity (%) Psychiatric Comorbidity in PTSD Major Depressive Episode GAD Panic Disorder Social Anxiety Disorder Alcohol Abuse/ Dependence Drug Abuse/ Dependence Kessler R et al. Arch Gen Psychiatry. 1995; 52:1048-1060.