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Transtorno do estresse pós-traumático

Última revisão: 13 Aug 2025
Última atualização: 04 Jun 2024

Resumo

Definição

História e exame físico

Principais fatores diagnósticos

  • exposição e resposta ao trauma
  • sintomas intrusivos
  • sintomas de evitação
  • alterações negativas nas cognições e humor
  • alterações no despertar e reatividade
Detalhes completos

Outros fatores diagnósticos

  • depressão
  • abuso de álcool ou de substâncias
  • ansiedade
Detalhes completos

Fatores de risco

  • acidente grave
  • testemunha de violência escolar ou doméstica
  • desastre natural
  • ataque terrorista
  • tortura
  • exposição a combate
  • lesão cerebral traumática
  • morte súbita de ente querido
  • ofensa grave
  • estupro
  • vitimização pelo atacante
  • trauma prévio
  • estressores múltiplos significativos na vida
  • apoio social baixo
  • história de transtorno mental
  • história de uso de álcool e drogas
  • sexo feminino
  • idade mais jovem
Detalhes completos

Investigações diagnósticas

Primeiras investigações a serem solicitadas

  • Checklist de TEPT para o DSM-5 (PCL-5)
  • Questionário de Rastreamento de Trauma (TSQ)
  • Escala de Diagnóstico Pós-Traumático (PDS-5)
  • Questionário Internacional de Trauma (ITQ)
Detalhes completos

Investigações a serem consideradas

  • Escala de TEPT Administrada pelo Clínico do DSM-5 (CAPS-5)
  • Entrevista da Escala de Sintomas de TEPT para DSM-5 (PSS-I-5)
  • Entrevista Internacional de Trauma (ITI)
Detalhes completos

Treatment algorithm

ONGOING

mulheres não gestantes ou amamentando

gestantes ou lactantes

Contributors

Authors

Mathew Hoskins, MBBCh, MSc, MRCPsych

Consultant Psychiatrist

Cardiff and Vale University Health Board

Cardiff

Wales

Disclosures

MH is Principal Investigator for a Phase 2 clinical trial of MDMA-assisted therapy in PTSD, sponsored by the Multidisciplinary Association of Psychedelic Studies; he has been reimbursed for training expenses. He is a co-founder of a medical cannabis private clinic in Wales and receives payment for consultations. MH is an author of references cited in this topic.

Catrin Lewis, BSc, PhD

Research Associate

National Centre for Mental Health

Institute of Psychological Medicine and Clinical Neurosciences

School of Medicine

Cardiff University

Cardiff

Wales

Disclosures

CL is one of the originators of Spring, a digital guided self help programme for PTSD. CL is an author of references cited in this topic.

Acknowledgements

Dr Mathew Hoskins, and Dr Catrin Lewis would like to gratefully acknowledge Dr Stanley Zammit, Dr Neil P. Roberts, Dr Jonathan I. Bisson, and Dr Steve Wood, previous contributors to this topic.

Peer reviewers

Mort Rubinstein, MD

Deputy Associate Chief of Staff

Mental Health

VA New York Harbor Healthcare System

Clinical Associate Professor

New York University School of Medicine

New York

NY

Disclosures

MR declares that he has no competing interests.

Neil Greenberg, MD, MRCPsych

Surgeon Commander

Royal Navy

Defence Professor of Mental Health, Visiting Professor of Psychiatry, and Co-Director

Academic Centre for Defence Mental Health

King's College London

London

UK

Disclosures

NG has been principal investigator on studies with research funding greater than 6 figures USD. NG is a director of a company providing early intervention training for traumatic stress (the company does not provide PTSD treatment services).

Peer reviewer acknowledgements

BMJ Best Practice topics are updated on a rolling basis in line with developments in evidence and guidance. The peer reviewers listed here have reviewed the content at least once during the history of the topic.

Disclosures

Peer reviewer affiliations and disclosures pertain to the time of the review.

References

Our in-house evidence and editorial teams collaborate with international expert contributors and peer reviewers to ensure that we provide access to the most clinically relevant information possible.

Key articles

American Psychiatric Association. Diagnostic and statistical manual of mental disorders, 5th ed., text revision (DSM-5-TR). Washington, DC: American Psychiatric Publishing; 2022.Full text

Phoenix Australia. Australian guidelines for the prevention and treatment of acute stress disorder, posttraumatic stress disorder and complex PTSD. 2021 [internet publication].Full text

National Institute for Health and Care Excellence. Post-traumatic stress disorder. Dec 2018 [internet publication].Full text

Benedek DM, Friedman MJ, Zatzick D, et al. Guideline watch (March 2009): Practice guideline for the treatment of patients with acute stress disorder and posttraumatic stress disorder. 2009 [internet publication].Full text

Reference articles

A full list of sources referenced in this topic is available to users with access to all of BMJ Best Practice.
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