Post-traumatic stress disorder: facts and fiction.
OBJECTIVE
This review provides an update on contemporary perspectives on post-traumatic stress disorder and challenges myths about the disorder and its treatment. Post-traumatic stress disorder has recently attracted public attention because of the impact of international terrorism, although the vast majority of post-traumatic stress disorder cases actually relate to civilian events such as car accidents, rape and violent robbery. This disorder requires deeper understanding and consensus among professionals.


RESULTS
Advances have been made in elucidating the neurobiology of this disorder, partly by using an animal model of post-traumatic stress disorder. Recent studies have focused on memory processes and the therapeutic role played by plasticity of the hypothalamic-pituitary-adrenal axis, and how this fits (or does not fit) in with the current therapeutic interventions. Guidelines have been established by various bodies in an attempt to streamline treatment options.


CONCLUSIONS
Understanding of post-traumatic stress disorder is incomplete. Future research should attempt to determine what treatments given during the 'window of opportunity' - the time from exposure until post-traumatic stress disorder develops - are effective. Care should be taken not to interfere with spontaneous recovery.
Zohar
Joseph
J
Chaim Sheba Medical Center, Department of Psychiatry, Tel Hashomer 52621, Israel. jzohar@post.tau.ac.il
Juven-Wetzler
Alzbeta
A
Myers
Vicki
V
Fostick
Leah
L
D000818:Animals; D001143:Arousal / Q000502:physiology; D001569:Benzodiazepines / Q000627:therapeutic use; D001921:Brain / Q000503:physiopathology; D003130:Combat Disorders / Q000175:diagnosis* / Q000503:physiopathology / Q000523:psychology / Q000628:therapy; D035881:Compensation and Redress; D003937:Diagnosis, Differential; D004195:Disease Models, Animal; D006624:Hippocampus / Q000503:physiopathology; D006801:Humans; D006854:Hydrocortisone / Q000097:blood; D007030:Hypothalamo-Hypophyseal System / Q000503:physiopathology; D008306:Malingering / Q000175:diagnosis / Q000523:psychology; D010913:Pituitary-Adrenal System / Q000503:physiopathology; D017410:Practice Guidelines as Topic; D012075:Remission, Spontaneous; D013313:Stress Disorders, Post-Traumatic / Q000175:diagnosis* / Q000503:physiopathology / Q000523:psychology / Q000628:therapy; D023481:Terrorism / Q000523:psychology
D001569:Benzodiazepines; D006854:Hydrocortisone