The National Institute for Clinical Excellence ( NICE ) has issued guidelines for the NHS on how to improve the recognition, screening and treatment of post traumatic stress disorder ( PTSD ) in children and adults in primary and secondary care.

PTSD can affect anyone and is common – around 5% of men and 10% of women will suffer from PTSD at some time in their life.
Up to 30% of people exposed to a stressful event or situation of an exceptionally threatening or catastrophic nature ( such as a natural disaster, war, torture, rape or sexual abuse ) will go on to develop PTSD.
Symptoms often develop immediately after the traumatic event, but the onset of symptoms may be delayed in some people.
There is under-recognition of the condition in the NHS, particularly in children, yet PTSD is treatable even when problems present many years after the traumatic event.

The guideline recommends that:

• Where symptoms are mild and have been present for less than 4 weeks after the trauma, watchful waiting, as a way of managing the difficulties presented by individual people with PTSD, should be considered.

• All others with PTSD should be offered a course of trauma-focused psychological treatment ( trauma-focused cognitive behavioural therapy or eye movement desensitisation and reprocessing ) on an individual outpatient basis.

• Children and young people with PTSD, including those who have been sexually abused, should be offered a course of trauma-focused cognitive behavioural therapy adapted as needed to suit their age, circumstances and level of development.

• Drug treatments for PTSD should not be used as a routine first-line treatment for adults ( in general use or by specialist mental health professionals ) in preference to a trauma-focused psychological therapy, but should be considered in adults who express a preference not to engage in trauma-focused psychological treatment.

• All disaster plans should contain provision for a fully coordinated psychosocial response to the disaster, and healthcare workers involved in a disaster plan should have clear roles and responsibilities agreed in advance.

• For individuals who have experienced a traumatic event the systematic provision to that individual alone of brief, single-session interventions that focus on the traumatic incident ( often referred to as debriefing ) should not be routine practice when delivering services.

Source: NICE, 2005


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