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Issue date: March 2005

Quick reference guide

Post-traumatic stress disorder
The management of PTSD in adults and
children in primary and secondary care

Clinical Guideline 26
Developed by the National Collaborating Centre for Mental Health

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Ordering information
Copies of this quick reference guide can be obtained from the NICE website at or from the NHS Response Line by telephoning
0870 1555 455 and quoting reference number N0848.
Information for the public on the guideline (`Post-traumatic stress disorder (PTSD): the
treatment of PTSD in adults…

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Patient-centred care 2

Grading of the recommendations 2

Key priorities for implementation 3

Post-traumatic stress disorder (PTSD) 5

Recognition 6
Recognition in primary care and general hospital settings 6
Specific recognition issues for children and young people 7

Screening 8
Screening after a major disaster 8
Screening refugees…

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Grading of the recommendations/Patient-centred care

Patient-centred care
Treatment and care should take into account patients' individual needs and
preferences. Good communication is essential, supported by evidence-based
information, to allow patients to reach informed decisions about their care.
Carers and relatives should have the chance to be involved in discussions

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Key priorities for implementation
Key priorities for implementation

The following recommendations have been identified as priorities for

Initial response to trauma
· For individuals who have experienced a traumatic event the systematic
provision to that individual alone of brief, single-session interventions
(often referred to as debriefing) that focus on…

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Key priorities for implementation

Children and young people
· Trauma-focused CBT should be offered to older children with severe
post-traumatic symptoms or with severe PTSD in the first month after the
traumatic event.

· Children and young people with PTSD, including those who have been
sexually abused, should be offered…

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Post-traumatic stress disorder (PTSD)

Post-traumatic stress disorder (PTSD)
PTSD can develop in people of any age following a stressful
event or situation of an exceptionally threatening or catastrophic nature.
PTSD does not usually develop following generally upsetting situations such
as divorce, loss of job, or failing an exam.
Up to…

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Recognition in primary care and general hospital settings

Symptoms typically associated with PTSD are as follows:

· re-experiencing ­ flashbacks, nightmares, repetitive and distressing intrusive
images or sensory impressions; in children, these symptoms may include: re-
enacting the experience, repetitive play or frightening dreams without
recognisable content


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Specific recognition issues for children and young people

· Do not rely solely on information from the parent/guardian in any
assessment for PTSD ­ ask the child or young person separately and directly
about PTSD symptoms. GPP

· Consider asking children and/or their parents/guardians about sleep
disturbance or significant…

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Screening after a major disaster
· Those coordinating the disaster plan should consider using a brief screening
instrument for PTSD 1 month after the event for individuals at high risk of
developing PTSD following a major disaster. GC

Screening refugees and asylum seekers
· Those managing refugee programmes…


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