Stein Dan J, Bandelow Borwin, Hollander Eric, Nutt David J, Okasha Ahmed, Pollack Mark H, Swinson Richard P, Zohar Joseph
Medical Research Council Research Unit on Anxiety Disorder, University of Stellenbosch, Cape Town, Tygerberg, South Africa.
CNS Spectr. 2003 Aug;8(8 Suppl 1):31-9. doi: 10.1017/s1092852900006921.
Posttraumatic stress disorder (PTSD) is a common and disabling condition. In addition to combat-related PTSD, the disorder occurs in civilians exposed to severe traumatic events, with the community prevalence rate for the combined populations reaching as high as 12%. If left untreated, PTSD may continue for years after the stressor event, resulting in severe functional and emotional impairment and a dramatic reduction in quality of life, with negative economic consequences for both the sufferer and society as a whole. Although PTSD is often overlooked, diagnosis is relatively straightforward once a triggering stressor event and the triad of persistent symptoms-reexperiencing the traumatic event, avoiding stimuli associated with the trauma, and hyperarousal have been identified. However, comorbid conditions of anxiety and depression frequently hamper accurate diagnosis. Treatment for PTSD includes psychotherapy and pharmacotherapy. The latter includes selective serotonin reuptake inhibitors (SSRIs), tricyclic antidepressants, and monoamine oxidase inhibitors. Only SSRIs have been proven effective and safe in long-term randomized controlled trials. Current guidelines from the Expert Consensus Panel for PTSD recommend treatment of chronic PTSD for a minimum of 12-24 months.
创伤后应激障碍（PTSD）是一种常见且致残的病症。除了与战斗相关的PTSD外，该病症还发生在经历严重创伤事件的平民中，这两类人群的社区患病率高达12%。如果不进行治疗，PTSD可能在应激源事件发生数年之后仍持续存在，导致严重的功能和情感障碍，生活质量大幅下降，给患者本人和整个社会都带来负面经济影响。尽管PTSD常常被忽视，但一旦确定了引发应激源事件以及持续性症状三联征——再次体验创伤事件、回避与创伤相关的刺激以及过度警觉，诊断相对较为简单。然而，焦虑和抑郁等共病状况常常会妨碍准确诊断。PTSD的治疗包括心理治疗和药物治疗。后者包括选择性5-羟色胺再摄取抑制剂（SSRI）、三环类抗抑郁药和单胺氧化酶抑制剂。只有SSRI在长期随机对照试验中被证明是有效且安全的。PTSD专家共识小组的现行指南建议，慢性PTSD的治疗时间至少为12至24个月。
