Should there be a clinical typology of posttraumatic stress disorder?
OBJECTIVE
The current classification of posttraumatic stress disorder in acute, chronic and delayed-onset types is incomplete and of limited usefulness. The present paper explores the possibilities of a clinically-based typology that would reflect both the patients' syndromic presentation and modern research findings.


METHODS
Review of current clinical and research literature, with a critical examination of proposed typologies, parameters utilised, applicability and relevance; elaboration of theoretical and practical bases of a clinical typology of posttraumatic stress disorder.


RESULTS
None of the existing posttraumatic stress disorder typologies presents a clinically comprehensive scope. A typology supported by literature findings and clinical observations is proposed. The six clinical types are depressive, dissociative, somatomorphic, psychotomorphic, organomorphic and 'neurotic-like'. Substance abuse and personality disorder-like variants remain as areas of investigation.


CONCLUSIONS
The proposed typology, while accepting the nuclear manifestations of posttraumatic stress disorder, highlights prominent coexisting symptoms that define the clinical appearance of different patients. The typological approach in posttraumatic stress disorder does not carry the ambiguities of comorbidity, and facilitates a more specific and appropriate management of the cases.
Alarcon
R D
RD
Department of Psychiatry and Behavioral Science, Emory University, Atlanta, Georgia, USA.
Deering
C G
CG
Glover
S G
SG
Ready
D J
DJ
Eddleman
H C
HC
D006801:Humans; D013313:Stress Disorders, Post-Traumatic / Q000145:classification*