Post-Traumatic Stress Disorder (PTSD)
Post Traumatic Stress Disorder (PTSD) is a Trauma and Stressor Related Disorder (previously included in Anxiety Disorders). One year prevalence in U.S. is estimated to be about 3.5% and in Europe 0.5%-1%, however prevalence rates increase among war veterans, individuals who have experienced rape, combat, captivity, genocide and individuals whose occupation involves higher risk of exposure at traumatic events (DSM-5). It has been estimated that approximately 40% of population affected by war or large scale natural disasters suffer from mental disorders or sub-threshold symptoms, whereas the most common diagnoses have been PTSD, Depression and Anxiety Disorders (World Health Organization [WHO], 2001).
Patients with PTSD have experienced or witnessed serious life-threatening event(s) or death, severe injury or sexual violence and suffer from intrusion symptoms re-experiencing the trauma (recurring thoughts, dreams, dissociative reactions, psychological distress or psyhcological reactions at exposure to stimuli that symbolize the traumatic event) as well as from:
persistent avoidance of memories (or loss of specific memories about the event);
avoidance of emotions and stimuli associated to the traumatic event (eg. places, people, activities, objects, situations);
cognitive distortions (self-blame, negative beliefs about self, others and the world);
negative mood related to the event (persistent diminished ability to feel positive emotions;
diminished interest in important activities, persistent horror, fear, anger, shame, guilt, feelings of detachment/estrangement from others); and
significant changes in arousal (exhibiting irritability, anger outbursts, startle, concentration problems, sleep disturbance, self-destructive behaviour, hypervigilance), (DSM-5; American Psychiatric Association, 2013).
Recognition of symptoms and assessment of symptoms and diagnosis of PTSD require mental health clinical expertise, interdisciplinary team work and screening programs, especially in regions that suffer a major disaster (National Institute for Clinical Excellence, 2005 [NICE], 2005). Treatment involves trauma-focused psychological interventions by specialised mental health professionals and possibly pharmacotherapy (NICE, 2005).
American Psychiatric Association. (2013). Diagnostic and statistical manual of mental disorders (5th ed.) Washington, DC; London, England: American Psychiatric Publishing.
National Institute for Clinical Excellence (2005). Post-traumatic stress disorder: management. NICE Clinical Guideline 26. Available at https://www.nice.org.uk/guidance/cg26. [NICE guideline]
World Health Organization. (2001). The world health report 2001. Mental Health. New Understanding. New Hope. Geneva WHO. Retrieved from http://www.who.int/whr/2001/en