Post-traumatic stress disorder as a nosological unit: difficulties of the past and challenges of the future

Abstract

Introduction. The impact of traumatic experiences has always been a part of human life. According to Judith Herman, an American psychotherapist, and professor at Harvard Medical School, "traumatic events overload a person's usual strategies for adapting to life, his usual security systems that give a sense of control, connection, and meaning." Also, traumatic events, for the most part, contain close personal contact with violence and death and pose a threat to life or physical integrity. For almost one year of the war, Ukrainian society faced a large number of negative phenomena capable of causing severe psychological trauma: disruption of the usual lifestyle, loss of family friends, and property, lack of many vital needs for a person, forced migration, uncertainty, a constant threat for health and life, etc. The purpose of the study was to analysis of scientific and literary data reflecting the history of the formation of the concept of "post-traumatic stress disorder" as a nosological unit, as well as the peculiarities of its manifestation and prevalence, diagnostic criteria. Materials and methods: A systematic search was conducted in the main electronic medical databases, such as PubMed, Scopus, Web of Science, Google Scholar, and processed publications that studied the history of the formation of "post-traumatic stress disorder" as a nosological unit, the features of its manifestation and prevalence. diagnostic criteria. Eligible studies were identified using keywords: post-traumatic stress disorder, psychotraumatology, trauma, physioneurosis, history of medicine. All types of articles were reviewed, including original studies, systematic reviews, and meta-analyses. Review and discussion: For a long time, there was a stigmatization of combat-related disorders in society. The path to the development of PTSD as a psychiatric diagnosis is long and thorny. After the World War II, there was an urgent need to introduce a standard unified nomenclature that would enable doctors from all over the world to have a common language for discussing the psychopathology of this disorder, establishing a diagnosis and determining disability. Over 60 years, starting in 1952, when the American Psychiatric Association (APA) introduced the concept of "brutal stress reaction" in its first edition of the Diagnostic and Statistical Manual of Mental Disorders (DSM-I) and up to 2013 (DSM-5) formation of post-traumatic stress disorder as a nosological unit was taking place. Conclusions: Despite the non-acceptance, stigmatization, indifference and other difficulties, PTSD finally achieved official status in the recognized list of diagnoses.

Keywords

• traumatic stress
• post-traumatic stress disorder
• psychotraumatology
• physioneurosis
• history of medicine