Delayed Onset of PTSD - A Problem for Diagnosis and Litigation - with Special Reference to Political Imprisonment in the GDR

Abstract

More often than is generally assumed: according to 2 metaanalyses, an average of about 25% of all cases of PTSD are not definitively diagnosed with post-traumatic stress disorder (PTSD) until 6 months or more after their trauma. Its prevalence varies widely depending on the given population. Delayed onset PTSD is diagnosed in military personnel much more often than in the civilian population (38,2 vs. 15,3%) . The divergence in PTSD's prevalence numbers is attributed to differences in its definition, methodology, and target population, as well as the type of trauma. The longer the observation period, the more likely it is that the PTSD diagnosis will be delayed. Several influencing factors have been identified for its emergence and persistence. Some experts insist that "bridge symptoms" be defined when patients are diagnosed as suffering from delayed onset PTSD. Although frequent, they are not necessarily present. We discuss an example thereof provided by political prisoners in the former GDR exhibiting different courses of PTSD as well as its delayed-manifestation subtype.