An estimated 700 000 Vietnam veterans – almost a quarter of all soldiers sent to Vietnam from 1964 to 1973 – required some form of psychological help. The prevalence of delayed and chronic PTSD, in spite of the careful prevention of psychiatric casualties in Vietnam itself, was a rude awakening. Trying to explain this paradox called for new hypotheses,

for instance, that PTSD might be a common form of psychiatric casualty in “low-level“ warfare.28 Similar profiles had been observed in the French Inhibitors,research,lifescience,medical post-colonial wars in Indochina and Algeria.29 This post- Vietnam syndrome, increasingly diagnosed in veterans in the seventies, ultimately led to the adoption of PTSD as a diagnostic category in 1980 in DSM-III. It seems puzzling that no such category existed in DSM-II, which had even abandoned the former DSM-’I

category of so-called ”gross stress reaction,“ when it was published in 1968, the Inhibitors,research,lifescience,medical year of the Communist Jet Offensive in Vietnam. Retrospect There is currently a measure of consensus on the diagnosis and phenomenological description of PTSD, which is recognized as a specific syndrome in individuals who have experienced a major traumatic event. Most modem textbooks concur in describing this syndrome as comprising three groups of symptoms: (i) the recurrent and distressing reexperiencing Inhibitors,research,lifescience,medical of the event in dreams, thoughts, or flashbacks; (ii) emotional mTOR inhibitor numbing and avoidance of stimuli reminiscent of the trauma; (iii) and a permanent state of increased Inhibitors,research,lifescience,medical arousal. The first symptoms of PTSD are often delayed and they are separated from the trauma by a latency period;

however, once installed, the disorder tends to follow a chronic course and the symptoms do not abate with time. DSM-IV 30 has the merit of clearly distinguishing PTSD, a chronic syndrome, from acute stress disorder, which is short-lived and appears soon after the trauma. We tend to abusively interpret the literature of previous decades as if today’s diagnostic categories Inhibitors,research,lifescience,medical had always existed. However, a clear distinction between acute stress disorder and chronic PTSD is usually lacking in previous works. Also, there was little attempt to predict the enough risk of developing PTSD. Providing the trauma is severe enough, most individuals will go on to develop PTSD. However, one puzzling question is that many survivors seemingly do not develop symptoms even after a severe stressor.31 Likewise, the historical literature on PTSD offers few clues concerning effective treatment, once the symptoms have become chronic. Jhe practice of forward treatment aiming to prevent the development of chronic disorders may have inspired today’s psychological debriefing of disaster victims.
The human response to psychological trauma is one of the most important public health problems in the world.