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Posttraumatic Stress Disorder: A Serious Mental Illness

Just as schizophrenia and bipolar disorder are considered serious mental illnesses, so should posttraumatic stress disorder (PTSD), a condition whose prevalence in the United States exceeds the combined prevalences of these other two disorders. People who have PTSD can expect, on average, to endure over two decades of active symptoms and to miss almost 1 day of work per week. They have a 20% chance of attempting suicide, an outcome that is not fully explained by the presence of comorbid depression (1, 2). The destructive effect of PTSD on intimate attachments and sources of support is well recognized. Overall, PTSD imposes a heavy burden on the health care system (3).

Can PTSD be effectively treated? Until about 5 years ago, we had only a limited appreciation of how effective treatment could be. What little we knew led us to believe that gains were only modest and treatment largely palliative. More recent reports of trials assessing selective serotonin reuptake inhibitors and exposure-based psychosocial therapies have fortunately painted a much brighter picture, and it is now justifiable, indeed best practice, to think of remission as the desired outcome (4, 5). It is also important to keep in mind that most survivors of trauma do not develop PTSD. Could innate human resilience have a protective effect? Is it possible to promote resilience with our known effective treatments? Evidence suggests that this may be so (4). The articles presented in this edition of Focus serve as timely elaborations on these themes.

REFERENCES

1. Kessler RC: Posttraumatic stress disorder: the burden to the individual and society. J Clin Psychiatry 2000; 61(suppl 5):4–14
2. Davidson JRT, Hughes DC, Blazer DG, George LK: Post-traumatic stress disorder in the community: an epidemiological study. Psychol Med 1991; 21:713–721[Medline]
3. Davidson JRT: Recognition and treatment of posttraumatic stress disorder. JAMA 2001; 286:584–588[Free Full Text]
4. Connor KM, Sutherland SM, Tupler LA, Malik ML, Davidson JR: Fluoxetine in post-traumatic stress disorder: randomised, double-blind study. Br J Psychiatry 1999; 175:17–22[Abstract/Free Full Text]
5. Hembree EA, Foa EB: Posttraumatic stress disorder: psychological factors and psychosocial interventions. J Clin Psychiatry 2000; 61(suppl 7):33–39[Medline]

Full Text (PDF) Email this article to a Colleague Similar articles in this journal Alert me to new issues of the journal Add to My Articles & Searches Download to citation manager Citing Articles via Google Scholar Articles by Davidson, J. R. T. Search for Related Content Articles by Davidson, J. R. T. Posttraumatic Stress Disorder

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