A 50 years old Shrilankan lady who was saved during the tsunami presented with complains of recalling the events during the disaster, remembering the apathy and sufferings of sufferers and the deaths during it. Which of the following is likely diagnosis?

Ans. A. PTSD. (Ref: Kaplan & Sadock's Synopsis of Psychiatry, Xth/Ch.16.5, Page no, 615).This lady who was saved during the tsunami presented with complains of recalling the events during the disaster, remembering the apathy and sufferings of sufferers and the deaths during it. The most likely diagnosis would be PTSD.Discussion:One of the most characteristic features of posttraumatic stress disorder (PTSD) is the occurrence of repeated dreams, flashbacks, and intrusive thoughts of the traumatic event. Hyperarousal, irritability, difficulties concentrating, exaggerated startle response, emotional numbing, avoidance of places and situations associated with the traumatic experience, dissociative amnesia, and a sense of foreshortened future are other symptoms displayed by patients with PTSD. Disturbance lasts > 1 month, with onset of symptoms beginning anytime after event, and causes significant distress, negative cognitive alterations, and/or impaired functioning.Treatment: psychotherapy, SSRIs.Obsessions and compulsions are experienced as alien and ego-dystonic and are the source of much distress.Specific phobias are charac- terized by an unreasonable or excessive fear of an object, an animal, or a situation (flying, being trapped in close spaces, heights, blood, spiders, etc.). Since the exposure to the feared situation, animal, or object causes an immediate surge of anxiety, patients carefully avoid the phobic stimuli. The diagnosis of specific phobia requires the presence of reduced functioning and interference with social activities and relationships due to the avoidant behavior, anticipatory anxiety, and distress caused by the exposure to the feared stimulus.