Post-traumatic stress disorder: what does NICE guidance mean for primary care?

Abstract

Post-traumatic stress disorder (PTSD) may develop following exposure to an extremely threatening or horrific event or series of events.1 Traumatic events which may lead to PTSD include: serious accidents; physical or sexual assault; abuse; work-related exposure to trauma; serious health problems or childbirth experiences; war and conflict; or torture. PTSD can affect people of any age. The estimated population prevalence of PTSD in adults in the UK is around one in 20 (4.4%), with similar rates observed between men and women.2 The symptoms of PTSD can cause considerable distress and may substantially impede social, educational, and occupational functioning.2 People with PTSD may also develop coexisting conditions including substance misuse and depression.3–5 PTSD is a treatable disorder, even for people who present many years after trauma. However, effective treatment can only take place if the disorder is recognised. GPs are frequently the first healthcare professional that a patient consults. A new National Institute for Health and Care Excellence (NICE) guideline on the assessment and management of people with PTSD6 has important, practical messages which should support GPs in the recognition of PTSD and the facilitation of timely access to effective PTSD treatments. In this editorial we outline the current challenges around the recognition of PTSD in primary care and the onward referral for treatment, and highlight the key NICE guideline recommendations relevant to GPs and what can be done to promote access to treatment for people with PTSD. PTSD can present with a range of symptoms. In adults, most common PTSD symptoms include: re-experiencing the traumatic event(s) in the form of distressing memories, flashbacks, or nightmares; avoidance of trauma-related reminders; and hypervigilance. Children, particularly when younger, may re-enact the traumatic experience through repetitive play …