Researchers describe how to diagnose WHO’s newly named ‘complex PTSD’

Researchers have described how to diagnose complex PTSD based on patient symptoms, following WHO’s new classification of the disorder, which differs from established PTSD.

Earlier this year, WHO published a new version of its International Classification of Diseases (ICD-11), which expanded upon PTSD with a new diagnosis for complex PTSD, or CPTSD. New symptoms, such as self-organization disturbances, were included in the diagnosis.

Andreas Maercker, PhD, MD, head of the division of psychopathology and clinical intervention at the University of Zurich, and colleagues assessed case findings of patients presenting with CPTSD.

“We elaborate how the CPTSD diagnosis can be made in routine situations in emergency medical facilities and in regions with underdeveloped health care systems, for example,” Maercker said in a press release accompanying the study. “This is particularly important, since not all countries use the WHO’s disease classification. Some have adopted the DSM-5 classification published by the American Psychiatric Association, which currently doesn’t list a diagnosis for complex PTSD.”

According to the study, a CPTSD diagnosis requires the presence of a traumatic sensor, which is defined as extremely threatening or a horrific event or series of events, as well as at least one symptom from each six symptom clusters — reexperiencing the event in the present; avoidance of traumatic reminders; sense of a current threat; affective dysregulation; negative self-concept; and difficulties in forming and maintaining personal relationships.

A diagnosis of CPTSD requires that these symptoms cause substantial impairment in functioning. According to the authors, unlike previous formulations of CPTSD, the type of trauma is a risk factor and not a requirement consideration of a CPTSD diagnosis.

“The development and evaluation of treatment approaches for complex PTSD is still at an early stage, and there are several key questions that are not yet settled,” Maercker and colleagues wrote. “Interventions from the psychodynamic, attachment and mindfulness frameworks remain to be investigated as standalone interventions or components within treatment programs.”