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Post-traumatic Stress Disorder

The DSM-IV criteria for PTSD can be summarized as a traumatic experience, or exposure to a traumatic event that is then reexperienced persistently, resulting in avoidance of stimuli associated with the event and persistent symptoms of increased arousal.

PTSD is a frequently occurring anxiety disorder, with estimates of life-time prevalence varying from 4% to 15%, depending on the criteria used and the group post-traumatic stress disorder.

Breslau et al reported on a study of 1007 young people in an urban area. The life-time prevalence for trauma in that group was 39%. The rate of PTSD in those exposed to trauma was 22.6%, yielding a life-time prevalence calculation in that group of 9.2%. It was also noted that those people with PTSD were at increased risk for


The treatment of these disorders is also changing. A summary of the efficacy of various therapies for PTSD was published in 1992. Solomon and her colleagues identified 225 reports of treatment of this illness, but focused on 11 that met the criteria of a systematic assessment based on DSM-III and DSM-IIIR. She concluded that drug studies appeared promising, but that behavioral techniques.

A study involving 64 patients over a 5-week period showed that the SRI, fluoxetine, was efficacious in treating patients with PTSD and its associated symptoms, especially in previously untreated patients. Another SRI, fluvoxamine, was used in a 10-week trial for Viet Nam combat veterans with chronic PTSD. Large treatment effects were noted within 4 to 6 weeks.

Although the treatment of this disabling disorder is still evolving, it appears certain that there is benefit to combining pharmacotherapy.