Consensus statement update on posttraumatic stress disorder from the international consensus group on depression and anxiety.

OBJECTIVE To provide an update to the "Consensus Statement on Posttraumatic Stress Disorder From the International Consensus Group on Depression and Anxiety" that was published in a supplement to The Journal of Clinical Psychiatry (2000) by presenting important developments in the field, the latest recommendations for patient care, and suggestions for future research. PARTICIPANTS The 4 members of the International Consensus Group on Depression and Anxiety were James C. Ballenger (chair), Jonathan R. T. Davidson, Yves Lecrubier, and David J. Nutt. Other faculty who were invited by the chair were Randall D. Marshall, Charles B. Nemeroff, Arieh Y. Shalev, and Rachel Yehuda. EVIDENCE The consensus statement is based on the 7 review articles in this supplement and the related scientific literature. CONSENSUS PROCESS Group meetings were held over a 2-day period. On day 1, the group discussed topics to be represented by the 7 review articles in this supplement, and the chair identified key issues for further debate. On day 2, the group discussed these issues to arrive at a consensus view. After the group meetings, the consensus statement was drafted by the chair and approved by all faculty. CONCLUSION There have been advancements in the science and treatment of posttraumatic stress disorder. Attention to this disorder has increased with recent world events; however, continued efforts are needed to improve diagnosis, treatment, and prevention of posttraumatic stress disorder.

[1]  C. Nemeroff,et al.  Neurobiology of posttraumatic stress disorder. , 2003, Current opinion in neurobiology.

[2]  Charlene K. Baker,et al.  Severity, timing, and duration of reactions to trauma in the population: an example from Mexico , 2003, Biological Psychiatry.

[3]  J. Buitelaar,et al.  Prenatal maternal stress: effects on pregnancy and the (unborn) child. , 2002, Early human development.

[4]  M. Shenton,et al.  Smaller hippocampal volume predicts pathologic vulnerability to psychological trauma , 2002, Nature Neuroscience.

[5]  Elizabeth M. Smith,et al.  Three-year follow-up of survivors of a mass shooting episode , 2002, Journal of Urban Health.

[6]  Patricia Cohen,et al.  Childhood adversities, interpersonal difficulties, and risk for suicide attempts during late adolescence and early adulthood. , 2002, Archives of general psychiatry.

[7]  D. Klein,et al.  A pilot study of noradrenergic and HPA axis functioning in PTSD vs. panic disorder , 2002, Psychiatry Research.

[8]  R. Heimberg.  Cognitive-behavioral therapy for social anxiety disorder: current status and future directions , 2002, Biological Psychiatry.

[9]  B. Rothbaum,et al.  Efficacy of sertraline in preventing relapse of posttraumatic stress disorder: results of a 28-week double-blind, placebo-controlled study. , 2001, The American journal of psychiatry.

[10]  Y. Gidron,et al.  Translating Research Findings to PTSD Prevention: Results of a Randomized–Controlled Pilot Study , 2001, Journal of traumatic stress.

[11]  E L Struening,et al.  Comorbidity, impairment, and suicidality in subthreshold PTSD. , 2001, The American journal of psychiatry.

[12]  J. Gorman,et al.  Variable foraging demand rearing: sustained elevations in cisternal cerebrospinal fluid corticotropin-releasing factor concentrations in adult primates , 2001, Biological Psychiatry.

[13]  C. Nemeroff,et al.  The role of childhood trauma in the neurobiology of mood and anxiety disorders: preclinical and clinical studies , 2001, Biological Psychiatry.

[14]  H. Kraemer,et al.  How do risk factors work together? Mediators, moderators, and independent, overlapping, and proxy risk factors. , 2001, The American journal of psychiatry.

[15]  R. Bonsall,et al.  Altered Pituitary-Adrenal Axis Responses to Provocative Challenge Tests in Adult Survivors of Childhood Abuse , 2001 .

[16]  C. Brewin,et al.  Meta-analysis of risk factors for posttraumatic stress disorder in trauma-exposed adults. , 2000, Journal of consulting and clinical psychology.

[17]  S. Levine,et al.  Stress-Induced Alterations in Corticotropin-Releasing Hormone and Vasopressin Gene Expression in the Paraventricular Nucleus during Ontogeny , 2000, Neuroendocrinology.

[18]  A. Ehlers,et al.  Psychological debriefing for road traffic accident victims , 2000, British Journal of Psychiatry.

[19]  M. Champoux,et al.  Rearing experiences and stress-induced plasma cortisol as early risk factors for excessive alcohol consumption in nonhuman primates. , 2000, Alcoholism, clinical and experimental research.

[20]  H. Westenberg,et al.  Serotonergic blunting to meta-chlorophenylpiperazine (m-CPP) highly correlates with sustained childhood abuse in impulsive and autoaggressive female borderline patients , 2000, Biological Psychiatry.

[21]  D. Hellhammer,et al.  The potential role of hypocortisolism in the pathophysiology of stress-related bodily disorders , 2000, Psychoneuroendocrinology.

[22]  C. Nemeroff,et al.  The impact of early adverse experiences on brain systems involved in the pathophysiology of anxiety and affective disorders , 1999, Biological Psychiatry.

[23]  R. Bryant,et al.  Treating acute stress disorder: an evaluation of cognitive behavior therapy and supportive counseling techniques. , 1999, The American journal of psychiatry.

[24]  R. Yehuda,et al.  Linking the neuroendocrinology of post-traumatic stress disorder with recent neuroanatomic findings. , 1999, Seminars in clinical neuropsychiatry.

[25]  Alan S. Brown,et al.  Prenatal Factors and Adult Mental and Physical Health , 1999, Canadian journal of psychiatry. Revue canadienne de psychiatrie.

[26]  Matcheri S Keshavan,et al.  Developmental traumatology part I: biological stress systems∗ ∗ See accompanying Editorial, in this issue. , 1999, Biological Psychiatry.

[27]  A. Harvey,et al.  Treatment of acute stress disorder: a comparison of cognitive-behavioral therapy and supportive counseling. , 1998, Journal of consulting and clinical psychology.

[28]  R. Yehuda,et al.  Psychoneuroendocrinology of post-traumatic stress disorder. , 1998, The Psychiatric clinics of North America.

[29]  M. Stein,et al.  Full and partial posttraumatic stress disorder: findings from a community survey. , 1997, The American journal of psychiatry.

[30]  M. Stein,et al.  Hippocampal volume in women victimized by childhood sexual abuse , 1997, Psychological Medicine.

[31]  R. Bronen,et al.  Magnetic resonance imaging-based measurement of hippocampal volume in posttraumatic stress disorder related to childhood physical and sexual abuse—a preliminary report , 1997, Biological Psychiatry.

[32]  F. Earls,et al.  Psychological and Neuroendocrinological Sequelae of Early Social Deprivation in Institutionalized Children in Romania , 1997, Annals of the New York Academy of Sciences.

[33]  R. Mayou,et al.  A randomised controlled trial of psychological debriefing for victims of road traffic accidents , 1996, BMJ.

[34]  E. Foa,et al.  Evaluation of a brief cognitive-behavioral program for the prevention of chronic PTSD in recent assault victims. , 1995, Journal of consulting and clinical psychology.

[35]  C. Coe,et al.  Abuse-Related Posttraumatic Stress Disorder: Evidence for Chronic Neuroendocrine Activation in Women , 1995, Psychosomatic medicine.

[36]  B. Lerer,et al.  Core symptoms of posttraumatic stress disorder unimproved by alprazolam treatment. , 1990, The Journal of clinical psychiatry.

[37]  R. Yehuda.  POST-TRAUMATIC STRESS DISORDER , 1985, The Lancet.

[38]  A. Shalev,et al.  Posttraumatic stress disorder as a result of mass trauma. , 2004, The Journal of clinical psychiatry.

[39]  J. Davidson.  Treatment of posttraumatic stress disorder: the impact of paroxetine. , 2003, Psychopharmacology bulletin.

[40]  C. Nemeroff,et al.  The role of early adverse experience and adulthood stress in the prediction of neuroendocrine stress reactivity in women: A multiple regression analysis , 2002, Depression and anxiety.

[41]  H. Prigerson,et al.  Preliminary explorations of the effects of prior trauma and loss on risk for psychiatric disorders in recently widowed people. , 2001, The Israel journal of psychiatry and related sciences.

[42]  J. Bremner.  Hypotheses and controversies related to effects of stress on the hippocampus: An argument for stress‐induced damage to the hippocampus in patients with posttraumatic stress disorder , 2001, Hippocampus.

[43]  J. Johnson,et al.  Associations between four types of childhood neglect and personality disorder symptoms during adolescence and early adulthood: findings of a community-based longitudinal study. , 2000, Journal of personality disorders.

[44]  R. Marshall,et al.  Implications of recent findings in posttraumatic stress disorder and the role of pharmacotherapy. , 2000, Harvard review of psychiatry.

[45]  D J Nutt,et al.  Consensus statement on posttraumatic stress disorder from the International Consensus Group on Depression and Anxiety. , 2000, The Journal of clinical psychiatry.

[46]  R. Yehuda.  Biology of posttraumatic stress disorder. , 2000, The Journal of clinical psychiatry.

[47]  Allen Frances,et al.  The expert consensus guideline series. Treatment of Posttraumatic Stress Disorder. The Expert Consensus Panels for PTSD. , 1999, The Journal of clinical psychiatry.

[48]  M. Keshavan,et al.  A.E. Bennett Research Award. Developmental traumatology. Part I: Biological stress systems. , 1999, Biological psychiatry.

[49]  M. Keshavan,et al.  A.E. Bennett Research Award. Developmental traumatology. Part II: Brain development. , 1999, Biological psychiatry.