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PTSD 1999-2000
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PRACTICE POINTS

Causes of Underdiagnosis

1. Symptoms in common with other conditions
2. Skepticism about diagnosis
3. Fail to ask about trauma
4. (Previous) lack of biological markers

The legal medicine specialist should detail all the possible additional diagnoses in questions for the psychiatrist who is to provide expert opinion

PTSD appears to be BIOLOGICALLY distinct from other psychological conditions with overlapping symptoms

PTSD is a dynamically changing condition that requires clinical reassessment every few months for medicolegal purposes

Prognostic Factors in PTSD

1. PTSD SYMPTOMS
   1. multiplicity
   2. severity
   3. duration
2. PRE-ACCIDENT
   1. PTSD
   2. anxiety or depression
3. current life STRESSORS
4. FAMILY history
   1. anxiety
   2. antisocial behaviour
5. poor social SUPPORT

Routinely ask psychiatric experts to complete the ten-minute PTSD Prognostic Checklist