Post-traumatic stress disorder (PTSD) is a mental health condition that can develop after a person has been exposed to one or more traumatic events — such as war, sexual assault, serious accidents, natural disasters, terrorism or any life-threatening situation. It is characterised by four symptom clusters: re-experiencing (intrusive memories, nightmares, flashbacks — feeling the trauma is happening again); avoidance (avoiding thoughts, feelings and reminders of the trauma); negative changes in cognition and mood; and hyperarousal (exaggerated startle, hypervigilance, irritability, sleep disturbance).

Not everyone who experiences trauma develops PTSD — approximately 20% of trauma-exposed people develop PTSD, with significant variation by trauma type (sexual assault has among the highest rates, ~50%). Risk factors: female sex (women develop PTSD at approximately twice the rate of men); prior trauma history; lack of social support; peritraumatic dissociation; and severity and proximity to the traumatic event. Protective factors: social support, perceived control, prior coping experience, and good psychological health before the trauma.

What are the symptoms?

Re-experiencing: intrusive, involuntary memories; distressing nightmares; flashbacks (feeling the event is happening again); intense distress or physiological reactions to reminders. Avoidance: of trauma-related thoughts, feelings, places, people, conversations. Negative alterations in cognition and mood: distorted blame of self; persistent negative emotional states; diminished interest in activities; feeling alienated. Hyperarousal: hypervigilance; exaggerated startle response; difficulty concentrating; irritability; sleep disturbance. In children: may present as disruptive behaviour, aggression, regression or somatic complaints.

What is the best treatment?

Trauma-focused psychological therapies are the most effective treatments for PTSD: prolonged exposure (PE), cognitive processing therapy (CPT) and EMDR all achieve similar response rates (60-80%) and are recommended by WHO, NICE and APA. These are superior to pharmacotherapy alone. Medications: SSRIs (sertraline, paroxetine — only FDA-approved medications for PTSD) or SNRIs provide symptom relief but have lower response rates than trauma-focused therapy. Combination of medication and therapy is used for severe cases.

Does PTSD resolve on its own?

Approximately 50% of people with PTSD show significant improvement or remission within 1 year without formal treatment — particularly after single-event traumas in people with good social support. However, PTSD becomes chronic in the other 50%, and chronic PTSD (lasting years) is harder to treat. Early intervention with trauma-focused therapy in the first weeks-months after trauma reduces PTSD chronification. Psychological first aid (not formal therapy) is the immediate intervention of choice in the acute aftermath of trauma.

What is complex PTSD?

Complex PTSD (C-PTSD) was introduced in ICD-11 (2019) for trauma survivors of prolonged, repeated interpersonal trauma — particularly childhood abuse, domestic violence, torture, trafficking or prolonged captivity. In addition to the core PTSD symptoms, C-PTSD includes disorders of self-organisation: persistent difficulties in emotion regulation; deeply negative self-concept (feeling permanently damaged, worthless or shameful); and persistent difficulties in sustaining relationships. C-PTSD typically requires longer, more complex treatment than single-event PTSD.

How does PTSD manifest in conflict zones?

In conflict-affected populations, PTSD prevalence reaches 20-30% (vs approximately 4-8% in general populations) — and comorbid depression, anxiety and substance use disorders amplify disability. WHO and UNHCR provide mental health support in humanitarian settings using Psychological First Aid (PFA) for acute trauma and mhGAP for longer-term treatment. Community-based approaches — peer support, social cohesion and community healing practices — are essential when professional mental health resources are absent.

How does MDMA-assisted therapy work for PTSD?

MDMA-assisted psychotherapy — involving 2-3 sessions where the patient takes MDMA while in intensive psychotherapy — has shown remarkable efficacy in Phase 2 and Phase 3 trials for treatment-resistant PTSD (67% no longer meeting PTSD criteria vs 32% placebo). The FDA rejected the first application in 2024 requesting additional trial data. Australia approved it in 2023. MDMA reduces fear response and increases openness, allowing patients to process traumatic memories that had been inaccessible in conventional therapy.

How does GMJ News cover PTSD?

GMJ News covers WHO PTSD burden data, trauma-focused therapy evidence, conflict-related PTSD, mhGAP implementation, EMDR and CPT efficacy, and emerging pharmacological approaches including MDMA-assisted therapy. PTSD is directly relevant to PHIG's mental health priorities — particularly in the context of Georgia's history of conflict and displaced populations — and to the Georgian Medical Journal.

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Post-Traumatic Stress Disorder (PTSD)

GMJ News knowledge hub · last reviewed September 2026 · Georgian Medical Journal

Summary Statistics Glossary GMJ news FAQ Documents Organizations Research

Post-traumatic stress disorder (PTSD) — a mental health condition triggered by exposure to traumatic events including conflict, sexual violence, disasters and accidents — affects an estimated 3.6-8% of the global population at some point in their lives, with rates reaching 20-30% in conflict-affected populations (WHO). PTSD causes intrusive re-experiencing of trauma, avoidance, negative alterations in cognition and mood, and hyperarousal — profoundly disrupting daily functioning and quality of life. Two trauma-focused psychological therapies — cognitive processing therapy (CPT) and EMDR (eye movement desensitisation and reprocessing) — have strong evidence bases and are recommended by WHO.

Key messages

3.6-8% lifetime prevalence

PTSD affects an estimated 3.6-8% of the global population at some point in their lives — with rates reaching 20-30% or higher in conflict-affected populations. An estimated 223 million people are living with PTSD globally (WHO/GBD).

War is the leading cause globally

While PTSD can follow any traumatic event — accident, disaster, assault, medical trauma — war and armed conflict are the most common causes globally. Countries experiencing or recovering from conflict have dramatically higher PTSD prevalence.

Trauma-focused therapies work

Cognitive processing therapy (CPT), prolonged exposure therapy (PE) and EMDR (eye movement desensitisation and reprocessing) are highly effective — achieving response in 60-80% of patients. WHO recommends all three for PTSD management.

mhGAP for PTSD

WHO's Mental Health Gap Action Programme (mhGAP) includes a PTSD module — enabling non-specialist health workers in LMICs to identify and provide first-line psychological support for trauma survivors, including in humanitarian settings.

Children and PTSD

Children exposed to trauma (abuse, war, disasters) are particularly vulnerable to PTSD — and may present differently from adults, with disruptive behaviour, regression, somatic complaints or trauma play rather than classic intrusive symptoms.

SSRI pharmacotherapy

SSRIs (sertraline, paroxetine — both FDA-approved for PTSD) and SNRIs (venlafaxine) are the primary pharmacological options. Prazosin reduces trauma nightmares. Antipsychotics are not recommended as monotherapy.

Key statistics

223M

estimated people with PTSD globally

WHO/GBD

3.6-8%

lifetime PTSD prevalence globally

WHO

20-30%

PTSD prevalence in conflict-affected populations

WHO

60-80%

response rate with trauma-focused therapy

WHO/NICE

higher PTSD rates in women vs men

WHO/GBD

50%

of PTSD resolves without treatment within 1 year

APA/WHO

PTSD prevalence (%) in conflict-affected vs general populations — WHO/GBD

Source: WHO and GBD. PTSD is dramatically elevated in conflict-exposed populations and refugees.

Glossary of key terms

Post-traumatic stress disorder (PTSD)
WHO/ICD-11/DSM-5A disorder developing after exposure to an extremely threatening or horrifying event — characterised by re-experiencing (intrusive memories, nightmares, flashbacks), avoidance of trauma reminders, negative alterations in thoughts and mood, and hyperarousal (startle, hypervigilance, sleep disturbance). Must persist for more than 1 month and cause significant impairment.

EMDR
WHO/APAEye Movement Desensitisation and Reprocessing — an evidence-based trauma therapy involving the patient recalling traumatic memories while following bilateral stimulation (typically therapist finger movements). Effectively processes traumatic memories and reduces PTSD symptoms. WHO and NICE recommend it as a first-line PTSD treatment.

Prolonged exposure (PE)
WHO/APAA trauma-focused CBT protocol — involving imaginal exposure (repeatedly recounting the traumatic memory in detail) and in-vivo exposure (approaching feared situations avoided since trauma). Highly effective — response rates 60-80%. Recommended by WHO and APA as first-line PTSD treatment.

Cognitive processing therapy (CPT)
WHO/APAA cognitive therapy for PTSD — focusing on identifying and modifying unhelpful "stuck points" (maladaptive beliefs about the trauma and its meaning). Does not require detailed narration of the trauma. Effective for various trauma types including sexual violence and combat trauma.

Complex PTSD (C-PTSD)
WHO/ICD-11A new diagnostic category in ICD-11 (not in DSM-5) — occurring after prolonged, repeated trauma (childhood abuse, domestic violence, torture, prolonged captivity). Includes PTSD plus disorders of self-organisation: affect dysregulation, negative self-concept and interpersonal difficulties.

Psychological first aid (PFA)
WHOA humane, supportive response to people affected by acute trauma — providing practical care and support without intrusive questions; helping meet basic needs; being present; helping access further support. The WHO-recommended immediate intervention in disaster and conflict settings — distinct from formal psychological therapy.