Another New DSM-V Diagnosis

Pager PTSD

Criteria for diagnosis:

1) Exposure to a constantly blaring pager; correlation has been found between an increased number of re-pages within 3 minutes (because the person wearing the pager was in a hallway with no phones, so the person paging felt the need to "try again") and severity of symptoms

2) Persistent reexperience; patient may have illusions of the pager going off or nightmares of missing pages

3) Persistent avoidance of stimuli associated with the pager trauma, ie, turning the pager off when not on call

4) Persistent symptoms of increased arousal, ie, sleeping with the call room light on so as not to sleep through a page, anger and cursing when the pager goes off, constant checking and rechecking of the pager when it is NOT going off to be sure the battery is intact

5) Duration of symptoms lasts longer than the exposure to the pager; patient may experience resurgence in anxiety when other people's pagers go off or may fumble for an imaginary pager when hearing the sound of another's pager

6) Significant impairment in occupational functioning such as cursing in front of patients when the pager goes off, snapping at auxiliary staff for paging incessantly, crying at work

Often comorbid with or must be differentiated from the following potential new DSM-V diagnoses:

1) Pager phobia--avoidance of pagers with increase in anxiety when the patient sees or hears a pager, reluctance to touch or wear a pager, patient must know symptoms are excessive

2) Pager OCD--compulsions of constant checking and rechecking of the battery; patient may even test-page him or herself to rest assured that the pager is working; obsessive thoughts of the pager not working or of beating it to a pulp Office Space style

3) Generalized call anxiety--anxiety and worries not just about the pager, but about the 40+ patients the intern on call is responsible for, interferes with sleep and appetite on call, patient may experience fatigue and muscle tension associated with call room bed and overweighted white coat pockets