A young male, victim of earthquake few months back, presented with complains of recurrent and intrusive recollection of the events and thoughts with anxiety causing disturbed routine life. The likely diagnosis is

Ans. a (Post-traumatic stress disorder). (Ref. Psychiatry by Niraj Ahuja, 5th ed., 115, 188)ACUTE STRESS DISORDER & POST TRAUMATIC STRESS DISORDERThese disorders are characterized by Severe Anxiety symptoms & follow a threatening event that caused feelings of Fear, Helplessness or Horror.# Acute Stress Disorder: Anxiety lasts < 1 month (but > 2 days)# Post Traumatic Stress Disorder (PTSD): Anxiety lasts > 1 month# May occur at any age# 50% of cases resolve within 3 months# symptoms begin immediately after trauma, but may occur after months / years# Re-experiencing of the Traumatic Event- Dreams, Flashbacks or Intrusive Recollections- Avoidance of Stimuli associated with the trauma or numbing of general responsiveness- Increased Arousal: Anxiety, Sleep disturbances & Hypervigilance# "Survivor guilt" - A feeling of irrational guilt about an event sometimes occurs.# Rx: Counseling after a stressful situation to prevent PTSD from developing. Group Psychotherapy with other survivors is helpful. Pharmacotherapy: ntidepressants (SSRI, TCAs) or Benzodiazepines