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Post-Traumatic Stress Disorder (PTSD)

NICE guideline [NG116] Post-traumatic stress disorder. Published: Dec 2018.

Background Information

PTSD could develop after experiencing or witnessing:

Serious accidents
Physical and sexual assault
Abuse, including childhood or domestic abuse
Work-related exposure to trauma, including remote exposure
Trauma related to serious health problems or childbirth experiences (for example, intensive care admission or neonatal death)
War and conflict
Torture

Guidelines

Some common symptoms:

Re-experiencing
Avoidance
Hyperarousal (including hypervigilance, anger and irritability)
Negative alterations in mood and thinking
Emotional numbing
Dissociation
Emotional dysregulation
Interpersonal difficulties or problems in relationships
Negative self-perception (including feeling diminished, defeated or worthless)

Consider active monitoring for those with subthreshold PTSD symptoms within 1 month of a traumatic event.

Do not offer psychologically-focused debriefing for the prevention or treatment of PTSD

1st line: individual trauma-focused CBT
- Consider group trauma-focused CBT if the event led to large-scale shared trauma
2nd line: eye movement desensitisation and reprocessing (EMDR)

Do not offer drug treatments for the prevention or treatment of PTSD in children and young people aged under 18 years

1st line: individual trauma-focused CBT interventions:

Cognitive processing therapy
Cognitive therapy for PTSD
Narrative exposure therapy
Prolonged exposure therapy

Eye movement desensitisation and reprocessing (EMDR) can be offered if:

Non-combat-related trauma, and
Preseted >1 month after the event

1st line: SSRISelective serotonin reuptake inhibitor (e.g. sertraline) or venlafaxine

Consider antipsychotics (e.g. risperidone) in addition to psychological therapies to manage symptoms if:

Disabling symptoms and behaviours (e.g. severe hyperarousal or psychotic symptoms) and
Failed to respond to other drug or psychological treatments

References

NICE guideline Post-traumatic stress disorder

Author: Adams Lau
Reviewer:
Last edited: 26/07/25

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