Researchers Release New Guidelines for Identifying, Treating Patients With New Complex PTSD Diagnosis

Following a new diagnosis from the World Health Organization (WHO) for complex post-traumatic stress disorder (PTSD), experts have summarized the symptoms and issued guidelines for clinical assessment and treatment.¹

PTSD is one of the most widely known responses to trauma, characterized by intrusive memories or flashbacks that may overwhelm patients with this condition. However, experts have noted for decades that some trauma survivors exhibit a broader pattern of psychological changes, particularly following prolonged or repetitive events, such as exposure to war, sexual abuse, or domestic violence. This broader group of symptoms is now known as complex PTSD.¹

According to the authors of the current study, complex PTSD affects up to 8% of the world population, including up to 50% of those who receive treatment in mental health facilities.2 According to data from the US Department of Veterans Affairs, approximately 12 million adults in the United States have PTSD during a given year, including approximately 8% of all women who will have PTSD sometime in their lives, compared to about 4% of all men.³

With decades of observational data, many experts have called for the diagnostic requirements for PTSD to be adapted. Earlier in 2022, the WHO issued a new version of its International Classification of Diseases, which now includes a new diagnosis for complex PTSD.¹

New symptoms, such as self-organization disturbances, were added to the previous symptoms of PTSD, which include flashbacks, nightmares, avoidance, social withdrawal, and hypervigilance. Key features of self-organization disturbances include excessive or heightened emotional responses, feelings of worthlessness, and persistent challenges in sustaining relationships and feeling close to others.¹

Following this diagnosis, an international team has published a study in The Lancet describing how to diagnose complex PTSD based on patient symptoms. The study includes descriptions of challenges that may occur, distinct features of complex PTSD in children and adolescents, and the diagnostic differences that need to be made to differentiate between complex PTSD and similar mental health disorders, such as severe depression, bipolar disorders, psychoses, or personality disorders.¹

The study also covers the latest findings on biopsychosocial correlations based on systematic selection criteria. Furthermore, the researchers analyzed the evidence for all available therapeutic studies and developed guidelines for treating complex PTSD.¹

“We elaborate how the complex PTSD diagnosis can be made in routine situations in emergency medical facilities and in regions with under-developed health care systems, for example,” first author Andreas Maercker, PhD, MD, said in a press release.¹

According to the researchers, 2 important goals of their study are to develop assessments for clinical use and to develop psychosocial therapies that could help patients manage or resolve their disorder. Future research should include multifactorial therapies including a focus on safety, psychoeducation, and collaboration between patients and providers, as well as treatment components that include self-regulatory strategies and trauma-focused interventions.²

REFERENCES

1. New Sibling Diagnosis for Post-Traumatic Stress Disorder. News release. University of Zurich. July 1, 2022. Accessed July 11, 2022. https://www.media.uzh.ch/en/Press-Releases/2022/Trauma.html

2. Maercker A, Cloitre M, Bachem R, Schlumpf Y, et al. Complex post-traumatic stress disorder. The Lancet; July 2, 2022. Accessed July 11, 2022. https://www.thelancet.com/journals/lancet/article/PIIS0140-6736(22)00821-2/fulltext

3. PTSD: National Center for PTSD. US Department of Veterans Affairs. Accessed July 11, 2022. https://www.ptsd.va.gov/understand/common/common_adults.asp