Posttraumatic Stress Disorder Workup

Updated: Sep 11, 2017
  • Author: T Allen Gore, MD, MBA, CMCM, DFAPA; Chief Editor: Randon S Welton, MD  more...
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Workup

Approach Considerations

Primary care and mental health providers can efficiently screen for PTSD using readily available self-administered tests. This should become standard of care as one study found that nearly half (48%) of the patients in general medical practices with PTSD were receiving no mental health treatment. One primary reason for this lack of treatment was providers not recognizing the diagnosis and recommending treatment. [34]  Mental health providers who do not ask about trauma may also miss the key role that PTSD plays in their patient’s symptoms.

There are a number of self-report scales that can be used for screening or management [59, 60, 61] :

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Lab Studies

There are no lab studies that are currently recommended for diagnosing PTSD, but they may be helpful in assessing for the substance use disorders, which commonly accompany PTSD.

Cortisol levels may be decreased, while norepinephrine and CRF levels may be elevated; however, these findings are currently used only for research. 

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Imaging Studies

While there are some consistent anatomical and functional studies in individuals with PTSD such as small hippocampi, decreased corpus collosum, decreased pre frontal cortex, increased reactivity in the amygdala, and decreased activity in the prefrontal cortex, these are currently used only for research.  

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Other Tests

Although increased arousal is not a required criterion for diagnosis, it might be measurable through studies of autonomic functioning (e.g., heart rate monitoring, electromyography, sweat gland activity).

Increased heart rate shortly after the traumatic event indicates an increased risk of PTSD.  

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