Post-Traumatic Stress Disorder

Understanding Post-Traumatic Stress Disorder

Post-traumatic stress disorder (PTSD) is a disorder that develops in some people following a traumatic event.

PTSD overview

The most common cause of PTSD is the unexpected death of a loved one,1 although there can be many possible causes, such as exposure to sexual violence, war, physical assault, a natural disaster, or a vehicle accident.2 A person may develop PTSD after experiencing the trauma themselves, witnessing it, or even learning about a trauma that affected a close relative or friend.2

 

PTSD is a serious and under-treated condition, which can occur at any age, and can have a negative effect on many social and economic aspects of people’s lives.2-4

Facts about Post-traumatic stress disorder

Post-traumatic stress disorder (PTSD) develops in some people after experiencing, witnessing, or learning about a traumatic event, such as the death of a loved one, exposure to sexual violence, war, physical assault, a natural disaster, or a vehicle accident.1 PTSD can have a negative effect on many social and economic aspects of people’s lives, as well as on society.2,3

People with PTSD may suffer from distressing memories and flashbacks, self-blame, inability to experience happiness, altered emotional responses (e.g., irritability, recklessness), and may actively avoid reminders of the traumatic event.1

Symptoms of PTSD

The symptoms of PTSD can be characterized into four main types:5

 

  • Re-experiencing the trauma – recurrent memories, nightmares, and flashbacks.
  • Avoidance symptoms – avoiding thoughts, feelings, objects, people, or places that are associated with the trauma.
  • Negative thoughts and emotions – exaggerated negative beliefs about oneself or the world, shame or guilt, reduced emotion, feeling alienated, and difficulty remembering details of the trauma.
  • Changes in arousal or emotional responses – irritability, being in a state of high alert, reckless behavior, sleep disturbance, and difficulty concentrating.

Symptoms of PTSD vary from person to person. Some people may predominantly experience one of the four symptom types, whereas others may experience a combination of symptoms.2 The timing of symptoms may also vary – most people with PTSD experience symptoms immediately after the traumatic event,3 whereas, in others, there may be a delay of months or even years before symptoms develop.2

70%

of people will experience a traumatic event in their lifetime, but most people recover normally.4,5

~ 3.9%

of all people worldwide experience PTSD in their lifetime; among people who have been exposed to trauma, the rate is approximately 5.6%.5

Epidemiology and burden

Worldwide, most people (70%) will experience a traumatic event in their lifetime.6 Although the majority of people exposed to trauma recover normally, approximately 5.6% of those exposed will develop PTSD.3 This equates to about 3.9% of all people experiencing PTSD in their lifetime.3 PTSD is more than twice as common in women than in men, and is more common in high-income countries than in low-income countries.3 Rates of PTSD are higher among veterans and others whose job increases the risk of exposure to trauma (e.g., police, firefighters, and emergency medical personnel).2

 

Some people with PTSD recover quickly, while others may have symptoms for many years.2 PTSD can have negative consequences in many aspects of people’s lives, including intimate relationships, friendships and socializing, parenting, finances, and work and academic performance.4

 

A global survey by the World Health Organization (WHO) found that people with PTSD miss an average of 15 additional days of work or activities per year, compared with people without PTSD,7 which can lead to substantial costs. In older people, symptoms of PTSD may be exacerbated by declining health, reduced cognitive abilities, and social isolation, adding to the burden of the disorder.2

Facts about Post-traumatic stress disorder

PTSD can occur at any age, even in very young children.1

PTSD can have a negative effect on intimate relationships, friendships and socializing, parenting, work and academic performance, and finances.2

People who are concerned that they – or their loved ones – are experiencing symptoms of PTSD should see their doctor for help and advice.

Diagnosis and care

People who are concerned that they – or their loved ones – are experiencing symptoms of PTSD should see their doctor for help and advice. PTSD is diagnosed using interviews with the patient, or with parents for young children.2 Symptoms of PTSD are often similar to symptoms of other disorders (such as depression), which can lead to underdiagnosis or misdiagnosis of PTSD.8 The key difference between PTSD and depression is that PTSD requires exposure to trauma.

 

Treatment of PTSD usually involves psychotherapy – tailored behavioral and emotional support from professionals – and may involve medication.9 However, a review of global data suggests that fewer than 50% of people with PTSD seek treatment.3 Furthermore, a delay in starting treatment can lead to worse outcomes.10 Early diagnosis and treatment are essential for people with PTSD.

  1. Kessler RC, Rose S, Koenen KC, Karam EG, Stang PE, Stein DJ, et al. How well can post-traumatic stress disorder be predicted from pre-trauma risk factors? An exploratory study in the WHO World Mental Health Surveys. World Psychiatry. 2014;13(3):265–274.
  2. American Psychiatric Association. Diagnostic and Statistical Manual of Mental Disorders. 5th ed. Arlington, VA: American Psychiatric Association; 2013.
  3. Koenen KC, Ratanatharathorn A, Ng L, McLaughlin KA, Bromet EJ, Stein DJ, et al. Posttraumatic stress disorder in the World Mental Health Surveys. Psychol Med. 2017;47(13):2260–2274.
  4. Rodriguez P, Holowka DW, Marx BP. Assessment of posttraumatic stress disorder-related functional impairment: a review. J Rehabil Res Dev. 2012;49(5):649–665.
  5. Lancaster CL, Teeters JB, Gros DF, Back SE. Posttraumatic stress disorder: overview of evidence-based assessment and treatment. J Clin Med. 2016;5(11).pii:E105.
  6. Benjet C, Bromet E, Karam EG, Kessler RC, McLaughlin KA, Ruscio AM, et al. The epidemiology of traumatic event exposure worldwide: results from the World Mental Health Survey Consortium. Psychol Med. 2016;46(2):327–343.
  7. Alonso J, Petukhova M, Vilagut G, Chatterji S, Heeringa S, Üstün TB, et al. Days out of role due to common physical and mental conditions: results from the WHO World Mental Health surveys. Mol Psychiatry. 2011;16(12):1234–1246.
  8. Brady KT, Killeen TK, Brewerton T, Lucerini S. Comorbidity of psychiatric disorders and posttraumatic stress disorder. J Clin Psychiatry. 2000;61(Suppl 7):22–32. 
  9. American Psychological Association. Guideline Development Panel for the treatment of posttraumatic stress disorder in adults. Clinical practice guideline for the treatment of PTSD. American Psychological Association; 2017.
  10. Maguen S, Madden E, Neylan TC, Cohen BE, Bertenthal D, Seal KH. Timing of mental health treatment and PTSD symptom improvement among Iraq and Afghanistan veterans. Psychiatr Serv. 2014;65(12):1414–1419.

  1. American Psychiatric Association. Diagnostic and Statistical Manual of Mental Disorders. 5th ed. Arlington, VA: American Psychiatric Association; 2013.
  2. Rodriguez P, Holowka DW, Marx BP. Assessment of posttraumatic stress disorder-related functional impairment: a review. J Rehabil Res Dev. 2012;49(5):649–665.
  3. Alonso J, Petukhova M, Vilagut G, Chatterji S, Heeringa S, Üstün TB, et al. Days out of role due to common physical and mental conditions: results from the WHO World Mental Health surveys. Mol Psychiatry. 2011;16(12):1234–1246.
  4. Benjet C, Bromet E, Karam EG, Kessler RC, McLaughlin KA, Ruscio AM, et al. The epidemiology of traumatic event exposure worldwide: results from the World Mental Health Survey Consortium. Psychol Med. 2016;46(2):327–343.
  5. Koenen KC, Ratanatharathorn A, Ng L, McLaughlin KA, Bromet EJ, Stein DJ, et al. Posttraumatic stress disorder in the World Mental Health Surveys. Psychol Med. 2017;47(13):2260–2274.

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