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Vasileva A.V.

Bekhterev National Medical Research Center for Psychiatry and Neurology;
Mechnikov North-Western State Medical University

Posttraumatic stress disorder clinical guidelines and treatment standards: focus on the symptoms of the psychophysiological arousal

Authors:

Vasileva A.V.

More about the authors

Journal: S.S. Korsakov Journal of Neurology and Psychiatry. 2024;124(5): 58‑68

DOI: 10.17116/jnevro202412405158

Read: 1827 times

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Table of contents

POSTTRAUMATIC STRESS DISORDER CLINICAL GUIDELINES AND TREATMENT STANDARDS: FOCUS ON THE SYMPTOMS OF THE PSYCHOPHYSIOLOGICAL AROUSAL
POSTTRAUMATIC STRESS DISORDER CLINICAL GUIDELINES AND TREATMENT STANDARDS: FOCUS ON THE SYMPTOMS OF THE PSYCHOPHYSIOLOGICAL AROUSAL

To cite this article:

Vasileva AV. Posttraumatic stress disorder clinical guidelines and treatment standards: focus on the symptoms of the psychophysiological arousal. S.S. Korsakov Journal of Neurology and Psychiatry. 2024;124(5):58‑68. (In Russ.)
https://doi.org/10.17116/jnevro202412405158

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The article describes the main diagnostic criteria and principles of posttraumatic stress disorder (PTSD) diagnostic with the consideration of risk factors and specific clinical features. The main biomarkers search trends and existing limitations are considered. The role of the psychophysiological arousal symptoms claster is highlighted in the clinical picture of PTSD as well as in connection with the main cluster of re-experiencing symptoms activation and slowing of sanogenesis process. The necessity of PTSD detection in somatic medicine is thoroughly described. The article presents therapeutic algorithms of the latest international and Russian PTSD treatment clinical guidelines based on the individual combination of psychotherapy and psychopharmacotherapy treatment choice. Additionally the accumulated during the last decades national clinical experience of the anxiety disorders treatment, including the symptoms of psychophysiological arousal is highlighted that determined the list of the recommended drugs indicating the evidence level, in the PTSD treatment standards and guidelines. The treatment choices possibilities with the consideration of different PTSD symptoms cluster expression and comorbid states and individual case distress level specific are presented. Main evidence based psychotherapeutic methods are described.

Keywords:

PTSD
flashback
anxiety
psychophysiological arousal
insomnia
startle reflex
somatization
adjustment disorder
cognitive-behavioral psychotherapy
treatment standards
clinical guidelines
psychopharmacotherapy

Authors:

Vasileva A.V.

Bekhterev National Medical Research Center for Psychiatry and Neurology;
Mechnikov North-Western State Medical University

Received:

23.04.2024

Accepted:

27.04.2024

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