The World Health Organization (WHO) recently added a new diagnosis for complex post-traumatic stress disorder to its list of conditions (CPTSD). Experts have now summarized the symptoms of the long-awaited new diagnosis and released clinical assessment and treatment guidelines.

The study explains how to make a complex post-traumatic stress disorder diagnosis based on the symptoms of those affected.
The study explains how to make a complex post-traumatic stress disorder diagnosis based on the symptoms of those affected. (Image: Istock.com/sarra22)

The World Health Organization (WHO) recently added a new sibling diagnosis for post-traumatic stress disorder (PTSD), complex post-traumatic stress disorder, to its list of PTSD diagnoses (CPTSD). An international team led by the University of Zurich has summarized the symptoms of the long-awaited new diagnosis and issued clinical assessment and treatment guidelines.

Post-traumatic stress disorder, or PTSD, is one of the most well-known reactions to trauma. People suffering from this mental disorder frequently experience intrusive memories or flashbacks that can be overwhelming. However, international experts have known for decades that some trauma victims or survivors exhibit a broader pattern of psychological changes, most commonly after prolonged or repetitive events such as war, sexual abuse, domestic violence, or torture, which is now known as CPTSD.

Expanded criteria

As a result, many experts have advocated for changes to the diagnostic criteria for PTSD. The World Health Organization (WHO) released a new version of its International Classification of Diseases earlier this year (ICD-11). A new diagnosis for complex post-traumatic stress disorder has been added to the updated ICD (complex PTSD). PTSD’s previous symptoms, such as flashbacks, nightmares, avoidance, social withdrawal, and hypervigilance, were joined by new symptoms such as self-organization disturbances. Excessive or heightened emotional responses, feelings of worthlessness, and persistent difficulties in sustaining relationships and feeling close to others are key characteristics of self-organization disturbances.

An international team led by UZH has published a study in The Lancet that details how to diagnose complex PTSD based on a patient’s symptoms. The study describes the difficulties that may arise, the distinguishing features of the disease in children and adolescents, and the diagnostic distinctions that must be made between closely related mental health disorders such as severe depression, bipolar disorders, psychoses, or personality disorders.

Diagnosis and treatment are described in detail.

“We elaborate on how the CPTSD diagnosis can be made in routine situations, for example, in emergency medical facilities and in regions with underdeveloped health care systems,” says first author Andreas Maercker, professor of psychopathology and clinical intervention at the University of Zurich. Based on systematic selection criteria, the study covers the most recent findings on biopsychosocial correlations. The researchers also examined the evidence base for all available therapeutic studies and created treatment guidelines for CPTSD.

“This is especially significant because not all countries use the WHO’s disease classification. Some have adopted the American Psychiatric Association’s DSM-5 classification, which currently lacks a diagnosis for complex PTSD “explains Maercker, emphasizing the importance of their research

Globally, a new classification has emerged.

The University of Zurich also helped to update the World Health Organization’s new International Classification of Diseases. Andreas Maercker of the UZH Department of Psychology and Marylene Cloitre of Stanford University advocated for a new diagnosis for complex post-traumatic stress disorder based on their own research and clinical experience. Furthermore, global surveys among psychiatrists and psychologists revealed a need for a more detailed assessment of this mental disorder. Following a systematic review of previous research as well as new findings, a new diagnosis for complex post-traumatic stress disorder was developed.

Source: Materials provided by the University of Zurich

 Reference:  DOI: 10.1016/S0140-6736(22)00821-2

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