Page 22 - Demo

Chapter 120Post-traumatic stressPost-traumatic stress disorder (PTSD) is a psychiatric disorder that may develop after experiencing or witnessing a traumatic event, such as actual or threatened death, serious injury or sexual violence.83 PTSD is characterized by intrusion symptoms, such as nightmares or flashbacks, avoidance of stimuli associated with the traumatic event, negative alterations in cognition and mood and alterations in arousal and reactivity, such as angry outbursts or difficulties with concentration.83 If these symptoms are present for more than one month, cause a significant impairment in functioning, and are not attributable to substance abuse or other medical conditions, someone fulfills the criteria of PTSD according to the Diagnostic and Statistical Manual of Mental Disorders-5.83 PTSD has a large impact on the quality of life, and makes it difficult for people to continue with their daily life activities. However, treatment has shown to be effective in both the general population and people with an intellectual disability, and may consist of eye movement desensitization and reprocessing therapy or cognitive behavior therapy.84, 85The reported lifetime prevalence of PTSD in the general population is about 4%, and 6% for those who have been exposed to traumatic events.86Individuals with an intellectual disability or other developmental delay may have an increased exposure to traumatic events and higher risks of developing PTSD.87-89 There has been only one study in individuals with 22q11.2DS, that reported a lifetime prevalence of PTSD of 0.9%,32 which is lower compared to the general population.86 However, only a minority of the participants in this study had reached adulthood. Scope of this thesisThe previous paragraphs provide a rationale for the study of several conditions in adults with 22q11.2DS including Parkinson’s disease, otolaryngologic and ophthalmologic conditions and post-traumatic stress, in addition to the study of retinovascular and retinoneural parameters. The studies described in this thesis are limited to the aforementioned topics that were selected because of their clinical relevance, few published studies on these topics so far and the clinical expertise of the specialized 22q11.2 clinics for adults at MUMC and ‘s Heeren Loo.