Diagnosis and Clinical Characteristics
These are the approved guidelines published by the South African Society of Psychiatrists to provide an overview on treatment and management of commonly diagnosed psychiatric illnesses. The guidelines include consensus recommendations, based on peer contribution and using the international evidence based guidelines that are suitable for the local South African health service.
Please note that parts of this guideline may be out of date, an update will be published as soon as it is available.
The disorder represents a pathological response to a traumatic event, characterised by symptoms of recurrent and intrusive distressing recollections of the event (e.g. nightmares, a sense of reliving the experience with illusions, hallucinations, or dissociative flashback episodes, intense psychological or physiological distress at exposure to cues that resemble the traumatic event); avoidance of stimuli associated with the trauma (e.g. inability to recall important aspects of the trauma, loss of interest, estrangement from others); and increased arousal (sleep disturbances, irritability, difficulty concentrating, hypervigilance, and exaggerated startle response).[5]
These symptoms cut across three recognised symptom clusters (re-experiencing, avoidance or numbing and hyper-arousal), produce distress and impairment for individuals, and form the essential targets for treatment. The Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-V) includes an additional cluster of symptoms characterised by negative alterations in cognition and mood. The full symptom picture must be present for more than 1 month for the diagnosis to be made.[6] PTSD is classified in the category of trauma- and stressor-related disorders, and separate from the anxiety disorders, in the DSM-V.
Risk factors that increase the likelihood of PTSD include severity of the traumatic exposure, history of past trauma or previous psychiatric disorder, female gender, experience of further stressful events and lack of social support.