Based on current meta-analytic research, it has been concluded that the prevalence of postpartum posttraumatic stress disorder was 3.1% in community settings and 15.7% in at-risk populations; however, those findings do state various limitations, including underreporting biases, across the examined studies which lead many researchers to believe the prevalence may be higher.As of right now, there are no widely recognized assessments that measure for postpartum posttraumatic stress disorder in clinical and medical settings. However, researchers and physicians will often use more reliable posttraumatic stress disorder questionnaires and assessments, which are unfortunately not always specific enough to the posttraumatic symptoms and experiences that are felt before, during, or after childbirth. One assessment for postpartum posttraumatic stress disorder, the City Birth Trauma Scale (CBTS), has been used in some research settings; however, it is not widely used in clinical and medical settings. The CBTS is a 29-item self-report questionnaire developed to measure birth-related posttraumatic stress disorder, according to the DSM-5 criteria of: symptoms of re-experiencing the event, avoidance, negative cognitions and mood, and hyperarousal, as well as the duration of ones symptoms and the amount of distress and impairment the symptoms have caused in the individuals life. The creators of the CTSB also added in two items from the DSM-IV that they felt were relevant to the population being assessed with this measure – that the mothers responded to the traumatic events during childbirth with intense fear, helplessness, or horror and that there were symptoms of emotional numbing.
Management
Differentiation of DIOS from constipation is generally performed by unit specializing in the treatment of cystic fibrosis. Adequate hydration and an aggressive regimen of laxatives are essential for treatment and prevention of DIOS. Osmotic laxatives such as polyethylene glycol are preferred. Individuals prone to DIOS tend to be at risk for repeated episodes and often require maintenance therapy with pancreatic enzyme replacement, hydration and laxatives (if the symptoms are also mild). Oral contrast instillation into the colon/ileum under radiological control has been found to reduce the need for surgical intervention. References
External links
http://www.cfmedicine.com/htmldocs/CFText/dios.htm
http://www.rbht.nhs.uk/healthprofessionals/clinical-departments/cystic-fibrosis/clinical-guidelines/nutritional-and-gastrointestinal-care/constipation-and-distal-intestinal-obstructive-syndrome/