Post-traumatic stress disorder and terrorism

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Abstract
Purpose of review Terrorist attacks are increasing in different parts of the world. The psychiatric consequences of terrorist attacks, particularly post-traumatic stress disorders, are often underrated. Recent terrorist attacks, particularly the attacks of September 11, 2001 in the USA, focused attention on post-traumatic stress disorder. This review examines the prevalence rates and characteristics of post-traumatic stress disorder after terrorist attacks. Recent findings At least 28-35% of people exposed to a terrorist attack may develop post-traumatic stress disorder. Whereas persons directly exposed to terrorist attacks have a greater risk of developing post-traumatic stress disorder, the secondary effects of vicarious exposure on people not directly exposed are significant. Individuals with post-traumatic stress disorder have higher healthcare utilization and medication use. More than 40% of people across the USA experienced substantial symptoms of stress after the attacks of September 11, 2001. The rates of acute post-traumatic stress disorder and depression among residents of lower Manhattan, New York, were twice the baseline rate 5-8 weeks after the attacks. The presence of pre-existing stressors, levels of social support, female sex, and Hispanic ethnicity were important predictors of post-traumatic stress disorder. Disaster-related television viewing could be harmful for children. The role of psychological debriefing in the prevention of post-traumatic stress disorder is questionable. Summary Most suffers of post-traumatic stress disorder are reluctant to see mental health professionals. Primary care physicians are best suited to identify and manage individuals with post-traumatic stress disorder. There is a need to train primary care practitioners in the identification and management of the psychiatric consequences of trauma and terrorism.

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