Post-traumatic stress disorder (PTSD) is a disabling serious psychiatric illness which has been increasing in prevalence in recent years. The diagnosis, epidemiology, pathophysiology and treatment of PTSD will be described with an emphasis on evidence based treatments. At the current time the vast majority of patients receive one of the two FDA approved treatments, sertraline or paroxetine with some percentage of patients treated with either one of the evidence-based psychotherapies (trauma focused Cognitive-behavior therapy or Cognitive Processing Therapy) or a combination of the two. In spite of advances in the field, the majority of patients do not achieve remission, though they do exhibit reductions in symptom severity as measured by the CAPS or PCL-5, the two most common dimensional measures utilized in this population. Risk factors for the development of PTSD will be described including a history of child abuse or neglect, as well as the nature of the index traumatic event and genetic factors. Pathophysiology studies using PTSD as the prototype gene X environment interaction disease will be described with an emphasis on candidate genes that have proven to be predictive of development of PTSD such as FKBP5 and CRHR1. The role of epigenetic mechanisms in the pathogenesis of PTSD will also be described and how this effects expression of critical genes. Brain imaging studies will be described highlighting structural and functional CNS changes in patients with PTSD and how they change with effective treatment. Finally and most importantly, each of the various treatment modalities that have been studied in PTSD will be reviewed in detail including various psychotherapies, pharmacotherapies, and novel treatments (ketamine, MDMA, Stellate ganglion injection). If time permits, management of treatment resistant PTSD will be discussed as well in the context of a case presentation.
Format
Recorded webinar, non-interactive, self-paced distance learning activity.
This presentation was recorded at the American Psychiatric Association Annual Meeting 2022.
Learning Objectives
- At the conclusion of this session, the participant will be able to describe the current understanding of how gene-environment interactions regulate vulnerability to develop PTSD.
- At the conclusion of this session, the participant will be able to describe all of the evidence-based treatments for PTSD, including psychotherapies and pharmacotherapies.
- At the conclusion of this session, the participant will be able to describe novel neuromodulation, psychotherapy and pharmacological approaches to treatment of PTSD.
Target Audience
Psychiatrists
Estimated Time to Complete
Estimated Duration: 90 minutes
Begin Date: October 1, 2023
End Date: October 1, 2026
Participants who wish to earn AMA PRA Category 1 Credit™ may do so after completing all sections of the course including the evaluation. After evaluating the program, course participants will be provided with an opportunity to claim hours of participation and print an official CME certificate (physicians) or certificate of participation (non-physicians) showing the completion date and hours earned.
Continuing Education Credit
In support of improving patient care, the American Psychiatric Association is jointly accredited by the Accreditation Council for Continuing Medical Education (ACCME), the Accreditation Council for Pharmacy Education (ACPE), and the American Nurses Credentialing Center (ANCC), to provide continuing education for the healthcare team.
The APA designates this live activity for a maximum of 1.50 AMA PRA Category 1 Credits™. Physicians should claim only the credit commensurate with the extent of their participation in the activity.
Physicians
The APA designates this enduring activity for a maximum of 1.5 AMA PRA Category 1 Credit ™. Physicians should claim only the credit commensurate with the extent of their participation in the activity.
Faculty and Planner Disclosures
The American Psychiatric Association adheres to the ACCME’s Standards for Integrity and Independence in Accredited Continuing Medical Education. Any individuals in a position to control the content of a CME activity — including faculty, planners, reviewers or others — are required to disclose all relevant financial relationships with ineligible entities (commercial interests). All relevant conflicts of interest have been mitigated prior to the commencement of the activity.
Program Presenters
- Charles Nemeoff, MD, PhD. Reports no financial relationships with commercial interests.
- Edmond Pi, MD. Reports no financial relationships with commercial interests.
Program Planners
- Jacqueline Maus Feldman, M.D., Chairperson, Scientific Program Committee, Reports no financial relationships with commercial interests.
- Robert O. Cotes, M.D., Vice-Chairperson, Scientific Program Committee, Reports no financial relationships with commercial interests.
- Uchenna Okeye, M.D., Vice-Chairperson, Scientific Program Committee, Reports no financial relationships with commercial interests.
Accessibility for Participants with Disabilities
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Technical Requirements
This internet-based CME activity is best experienced using any of the following:
- The latest and 2nd latest public versions of Google Chrome, Mozilla Firefox, or Safari
- Internet Explorer 11+
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Optimal System Configuration:
- Browser: Google Chrome (latest and 2nd latest version), Safari (latest and 2nd latest version), Internet Explorer 11.0+, Firefox (latest and 2nd latest version), or Microsoft Edge (latest and 2nd latest version)
- Operating System: Windows versions 8.1+, Mac OS X 10.5 (Leopard) +, Android (latest and 2nd latest version), or iOS/iPad OS (latest and 2nd latest version)
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Minimum Requirements:
- Windows PC: Windows 8.1 or higher; 1 GB (for 32-bit)/2 GB (for 64-bit) or higher RAM; Microsoft DirectX 9 graphics device with WDDM driver; audio playback with speakers for programs with video content
- Macintosh: Mac OS X 10.5 or higher with latest updates installed; Intel, PowerPC G5, or PowerPC G4 (867MHz or faster) processor; 512 MB or higher RAM; audio playback with speakers for programs with video content
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