Post-Traumatic Stress Disorder:
The Management of PTSD in Adults and Children in Primary and Secondary Care
National Collaborating Centre for Mental Health (NCCMH)
This evidence-based clinical guideline commissioned by NICE
(National Institute for Clinical Excellence) presents guidance on
the management of post-traumatic stress disorder (PTSD) in primary
and secondary care.
This volume includes all the evidence on which the guideline
statements are based, and a detailed explanation of the methodology
behind the guideline's preparation. Comprehensive information about
PTSD (including prevalence, risk factors and diagnosis) and
testimonies from PTSD sufferers are also provided.
An essential resource for all professionals involved in the
management of PTSD, this book is a milestone in the development of
truly independent and transparent clinical guidance and an
essential tool in improving the quality of mental health care in
the UK.
Included is a data CD-ROM presenting:
- Full details of studies included in the guideline and reasons
for excluding studies, with reference list.
- A full list of guideline statements.
- All meta-analytical data presented as forest plots.
- Detailed information about how to use and interpret forest
plots.
*Highly commended for the Mental Health prize
of the 2006 BMA Medical Book Competition.*
“It is very welcome that this National
Clinical Practice Guideline on Post Traumatic Stress Disorder has
been developed by an expert group under the auspices of the
National Collaborating Centre for mental health – a branch of the
National Institute for Health and Clinical Excellence (NICE). …It
is easy to read and well referenced. Highly recommended.”
Primary Care and Community
Psychiatry
Full Contents
Guideline Development Group membership
Acknowledgements
List of abbreviations
1. Introduction
1.1 - National guidelines
1.2 - The national PTSD guideline
2. Post-traumatic stress disorder
2.1 - The disorder
2.2 - Incidence and prevalence
2.3 - Diagnosis and differential diagnosis
2.4 - Aetiology of PTSD
2.5 - Treatment and management of PTSD in the NHS
2.6 - Primary care
2.7 - Economic burden of PTSD
3. Experiences of PTSD sufferers and
carers
3.1 - Personal testimonies from PTSD sufferers
3.2 - Understanding PTSD from the sufferer’s perspective
3.3 - Summary of PTSD sufferer concerns
3.4 - Carers’ testimonies
3.5 - Understanding the impact of PTSD on carers
3.6 - Summary of carer needs
3.7 - Clinical practice recommendations
4. Methods used to develop this
guideline
4.1 - Overview
4.2 - The Guideline Development Group
4.3 - Clinical questions
4.4 - Systematic clinical literature review
4.5 - Health economics review strategies
4.6 - Stakeholder contributions
4.7 - Validation of this guideline
5. Psychological treatment of PTSD in
adults
5.1 - Introduction
5.2 - Definitions
5.3 - Previous systematic reviews
5.4 - Studies considered for review
5.5 - Evidence statements
5.6 - Clinical summary for psychological treatments
5.7 - Recommendations for psychological treatments for chronic
PTSD
5.8 - Research recommendations
6. Pharmacological and physical interventions for PTSD
in adults
6.1 - Introduction
6.2 - Current clinical practice
6.3 - Limitations of the literature: comparing RCTs of
pharmacological and psychological treatment
6.4 - Issues and topics covered by this review
6.5 - Studies included
6.6 - Study characteristics
6.7 - General issues arising in the management of antidepressant
medication
6.8 - Repetitive transcranial magnetic stimulation
6.9 - Clinical summary
6.10 - Clinical practice recommendations
6.11 - Research recommendations
7. Early intervention for PTSD in
adults
7.1 - Introduction
7.2 - Current practice
7.3 - Studies included
7.4 - Treatment for all
7.5 - Treatment for all – clinical summary
7.6 - Early psychological interventions for acute PTSD and acute
stress disorder
7.7 - Clinical summary of early psychological interventions
7.8 - Early intervention drug treatments for PTSD
7.9 - Clinical summary of early intervention drug treatments
7.10 - Economic evaluation of early versus later delivery of
psychological treatment
7.11 - Clinical practice recommendations
8. Predictors of PTSD and screening for the
disorder
8.1 - Introduction
8.2 - Risk factors
8.3 - Screening
8.4 - Clinical practice recommendations
8.5 - Research recommendations
9. Children and young people with PTSD
9.1 - Introduction
9.2 - Developmental differences
9.3 - Incidence, prevalence and natural history
9.4 - Diagnostic and assessment measures
9.5 - Psychological interventions
9.6 - Clinical summary of psychological interventions
9.7 - Pharmacological interventions
9.8 - Clinical summary of pharmacological interventions
9.9 - Clinical practice recommendations
9.10 - Research recommendations
10. Special considerations
10.1 - Introduction
10.2 - Disaster planning
10.3 - Ex-military personnel
10.4 - Phased interventions in settings of continuing threat
10.5 - Working with refugees and asylum seekers
10.6 - Role of the non-statutory sector
10.7 - Recommendations
11. Summary of recommendations
11.1 - Key recommendations for implementation
11.2 - Guidance
11.3 - Recognition of PTSD
11.4 - Assessment and coordination of care
11.5 - Support for families and carers
11.6 - Practical support and social factors
11.7 - Language and culture
11.8 - Care for all people with PTSD
11.9 - Treatment of PTSD
11.10 - Disaster planning
11.11 - Research recommendations
Appendices
References