Post-traumatic stress disorder (PTSD) is the development of characteristic and persistent
symptoms, along with difficulty functioning after exposure to a life-threatening
experience or to an event that either involves a threat to life or serious injury.
Symptoms of PTSD may diminish with the passage of time, or they may persist for many
years. PTSD often occurs together with, or precedes other psychiatric illnesses.
Patients are most likely to present to primary care with unexplained somatic and/or
psychological symptoms (e.g., sleep disturbance, night sweats, fatigue, and difficulty
with memory or concentration). The common symptoms after exposure to trauma are included
The symptoms required for the diagnosis of PTSD may be divided into 3 clusters and
should be present for at least 1 month.
• Intrusion or re-experiencing - memories of the trauma or "flashbacks" that occur
unexpectedly; these may include nightmares, intrusive mental images or extreme emotional
distress, and/or physiological reactivity on exposure to reminders of the traumatic
• Avoidance - avoiding people, places, thoughts, or activities that bring back memories
of the trauma; this may involve feeling numb or emotionless, withdrawing from family
and friends, or "self-medicating" by abusing alcohol or other drugs.
• Hyperarousal - feeling "on guard" or irritable, having sleep problems, having difficulty
concentrating, feeling overly alert and being easily startled, or having sudden outbursts