In recent years, between attacks and natural disasters, we have heard a lot about post-traumatic stress disorder (PTSD). These disorders result in moral suffering and physical complications which profoundly alter personal, social and professional life.

Post-traumatic stress disorder, also called post-traumatic stress disorder (PTSD) occurs when a person has been confronted with an event generating significant and sudden distress, where his or her physical integrity or that of others has been threatened. Witnessing death or serious injury to another person is also considered a traumatic event. In such situations, a person may experience fear of dying, a high level of anxiety, characterized by a feeling of intense fear. Normal reactions that usually go away a month after the event. But in people with PTSD, reactions persist. The person relives the traumatic situation in the form of dreams, flashbacks, with the same intensity. The consequences on his family and social life can be significant.

Some examples of traumatic events:

• Natural disasters: tsunami, hurricane, landslide, flood;
• Accidents: drowning, electrocution, severe burns, car or work accident; 
• Physical or sexual assault, domestic violence;
• Military combats, war situations;
• Death threats.

The onset of emotional and behavioral symptoms varies and can begin in the first few weeks or for some, in the first months or even more than six months after the event, what is called a delayed onset. Next comes, which is the most common sign, the repetition syndrome which is characterized by recurrent nightmares of the traumatic event that disrupt sleep. Emotional flashbacks in which people relive the event as if it happened again and not through mere memories. These visions are followed by panic attacks and sometimes, screaming. The day is not exempt from nightmarish images either. The subject may also present with pseudo-depressive manifestations and unusual vigilance or mistrust. 

PTSD is also manifested by:

• intrusive thoughts;
• intense neurovegetative reactions;
• avoidance behaviors and disturbances in cognition and mood. 

Although the difficulties associated with this disorder may gradually ease, they tend to persist, lasting for years and even a lifetime.

Faced with the same event, the risk of developing such disorders depends on pre-existing factors specific to the patients and the context in which the consequences of the event take place.

Untreated post-traumatic stress can lead to complications such as depression, suicidal thoughts, addictive behavior. The management mainly involves medication and psychological interventions.

Medication

Although trauma-focused psychotherapy remains the safest and most effective way to treat PTSD, medication has several benefits that should not be overlooked. On the one hand, it is more easily accessible, is less expensive and requires less time than psychotherapy. Medication is therefore an interesting alternative to this day.

Trauma-Centered Cognitive Behavioral Therapy (CBT-T)

It is the best choice for treating PTSD. Its effectiveness has been repeatedly demonstrated through dozens of scientific studies carried out in different countries. In recent years, a new form of psychotherapy has been found to be effective in treating PTSD: EMDR (Eye movement Desensitization and Reprocessing). EMDR, which has several similarities with TCC-T), has the particularity of using stimulation of the senses (sight, hearing or touch) as the main tool for change. Relatives of victims also have an important role in providing them with help in several ways, such as by offering empathetic listening, concrete and immediate help, advice, or even by sharing pleasant activities.

Concerning direct or indirect witnesses of terrorist acts, several epidemiological investigations have recently been carried out in France, in collaboration with teams from Inserm. Thus, 6 to 18 months after the January 2015 attacks (Charlie Hebdo, Hyper Kosher, Montrouge, Dammartin-en-Goële), 18% of witnesses presented PTSD, with a prevalence ranging from 3% among nearby witnesses and up to ‘to 31% among people directly threatened.

The traumatic experience is a common event with significant psychic consequences, since 5% of men and 10 to 12% of women have suffered from PTSD in their lifetime, sometimes for several years. About 80% of subjects who have presented with PTSD suffer from concomitant psychiatric disorders.

When men and women are compared for the same type of event, the frequency and severity of PTSD remains greater in women. It therefore seems that they are more vulnerable, but the reasons for this fragility remain uncertain.