Variceal haemorrhage and post-traumatic stress disorder

Objective. Post-traumatic Stress Disorder (PTSD) is thought to be relativel y common following extremely distressing life-threatening events. Patients with liver cirrhosis can experience severe brisk variceal haemorrhage durin g which they vomit litres of blood and may exsanguinate. We predicted that a significant proportion of survivors would suffer from PTSD. Design. PTSD assessment of 30 patients who had a haematemesis of more than four units of blood secondary to variceal bleeding and were fully conscious at the time of the bleed. Method. Structured Clinical Diagnostic Interview (SCID-DSM-III-R) and self- report measures. Results. Most found the experience distressing, but only 1 out of 30 patien ts fulfilled DSM-III-R diagnostic criteria for PTSD. Conclusion. PTSD in a sample of patients who survived life-threatening vari ceal haemorrhage is much rarer than might reasonably have been anticipated. Possible reasons for this low prevalence of PTSD are discussed.