Post-Traumatic Stress Disorder: Evolution of Views

Abstract

Background: among the psychological and psychiatric consequences of life-threatening situations, the problem of post-traumatic stress disorder (PTSD) is invariably of leading importance. At the same time, diagnostic and therapeutic approaches to solving this problem have undergone significant changes over the past decades.The aim of review is the analysis of scientific materials on the problems of PTSD with the use search systems, to highlight the evolution of views on the clinic, pathogenesis, approaches to the treatment of this disorder and to formulate promising directions for further research in this area.Material and methods: a review of more than 60 scientific papers containing scientifically based information on the diagnostic and therapeutic and preventive aspects of PTSD was conducted using the resources of search engines, including PubMed and eLibrary, for the keywords “post-traumatic stress disorder”, “PTSD”. Results: at present, relatively weak progress in the field of clinical diagnostics is being noted, noticeably lagging behind the results of research in the field of neurophysiology of PTSD, primarily the molecular biology of operant conditioning and extinction of fear reactions, as a result of which this disease is still a diagnostic puzzle.Conclusion: it is expedient to search for clearer, non-overlapping with other taxonomic units, clinical symptoms and signs with “PTSD pathognomonicity” on the basis of phenomenological and network approaches that allow to eliminate the limitations of polythetical categorization, whereas in genetic studies, on the contrary, the rejection of the methodology looks more promising “case/control” and the transition to the “binding” of the detected polymorphisms to the transnosological characteristics. It is necessary to develop effective methods for the prevention of stress-associated disorders in military personnel, in general, including programs to increase stress resistance, as well as domestic multimodal software and hardware complexes to optimize the treatment and prevention of PTSD.