PTSD



Posttraumatic stress disorder (PTSD)[note 1] is a mental disorder that can develop after a person is exposed to a traumatic event, such as sexual assault, warfare, traffic collisions, or other threats on a person’s life.[1] Symptoms may include disturbing thoughts, feelings, or dreams related to the events, mental or physical distress to trauma-related cues, attempts to avoid trauma-related cues, alterations in how a person thinks and feels, and an increase in the fight-or-flight response.[1][3] These symptoms last for more than a month after the event.[1] Young children are less likely to show distress, but instead may express their memories through play.[1] A person with PTSD is at a higher risk for suicide and intentional self-harm.[2][6]

Most people who experience a traumatic event do not develop PTSD.[2] People who experience interpersonal trauma such as rape or child abuse are more likely to develop PTSD, as compared to people who experience non-assault based trauma, such as accidents and natural disasters.[7] About half of people develop PTSD following rape.[2][8] Children are less likely than adults to develop PTSD after trauma, especially if they are under 10 years of age.[9] Diagnosis is based on the presence of specific symptoms following a traumatic event.[2]

Prevention may be possible when counselling is targeted at those with early symptoms but is not effective when provided to all trauma-exposed individuals whether or not symptoms are present.[2] The main treatments for people with PTSD are counselling (psychotherapy) and medication.[3][10] Antidepressants of the selective serotonin reuptake inhibitor type are the first-line medications for PTSD and result in benefit in about half of people.[4] Benefits from medication are less than those seen with counselling.[2] It is not known whether using medications and counselling together has greater benefit than either method separately.[2][11] Other medications do not have enough evidence to support their use and, in the case of benzodiazepines, may worsen outcomes.[12][13]

In the United States, about 3.5% of adults have PTSD in a given year, and 9% of people develop it at some point in their life.[1] In much of the rest of the world, rates during a given year are between 0.5% and 1%.[1] Higher rates may occur in regions of armed conflict.[2] It is more common in women than men.[3] Symptoms of trauma-related mental disorders have been documented since at least the time of the ancient Greeks.[14] During the World Wars, the condition was known under various terms including “shell shock” and “combat neurosis”.[15] The term “posttraumatic stress disorder” came into use in the 1970s in large part due to the diagnoses of U.S. military veterans of the Vietnam War.[16] It was officially recognized by the American Psychiatric Association in 1980 in the third edition of the Diagnostic and Statistical Manual of Mental Disorders (DSM-III).[17]

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