Psychological distress is part of a normal human response to overwhelming experiences. The definition of specific diagnostic criteria has prompted considerable empirical research and theoretical debate. The term post-traumatic stress disorder (PTSD) emphasised that a single disorder accounted for the psychopathological consequences of all traumatic events such as combat, rape and life-threatening accidents. It was not until 1980, however, with the advent of the Diagnostic and Statistical Manual of Mental Disorders (DSM-III), 1 that the disorder was formally recognised. Historically, terms such as shell shock, battle fatigue and compensation neurosis have been used to describe the psychological effects of trauma. References appear as far back as Homer's Iliad. The history of reactions to trauma goes back for many hundreds of years. Referral for intensive treatment should be made in more severe cases. Several strategies may be adopted by primary health care providers to assist patients with both acute and chronic forms of the disorder. The possible existence of the disorder can be ascertained with a few simple questions. In its more serious forms, it is a chronic and disabling psychiatric disorder associated with high comorbidity and impairment of functioning. It is a common anxiety disorder in Australia with a 12-month prevalence of 3.3%. Post-traumatic stress disorder (PTSD) has been the focus of considerable attention, and some controversy, since it was formally recognised in 1980.
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