Post-traumatic stress disorder: Clinical aspects and pharmacological approach

All medical specialities are interested in the clinical aspects of psychological trauma. Due to psychopathological determinants which structure the trauma, although pathognomonic of posttraumatic stress disorder, flashbacks arc. rarely highlighted by the psychotraumatised patient in their contact with the health care system. Contact with the medical profession is expressed by somatic symptoms or psychiatric comorbidities. Addictive and suicidal problems, as well as somatisations and physical pain, are more traditional methods of contact with the health care system. In relation to the evolution of investigative techniques, modern wars have highlighted other dissociative and psychotic dimensions of the psycho- and craniatraumatic repercussions. These different clinical forms of posttraumatic stress disorder can receive a specific pharmacological treatment according to the predominant impairment of the incriminated monoaminergic neuromodulatory system. (C) 2012 Published by Elsevier Masson SAS on behalf of the Societe nationale francaise de medecine interne (SNFMI).