Post-traumatic stress disorder: symptom profiles in men and women

Objective: To investigate the symptom frequencies of a relatively large sample of post-traumatic stress disorder (PTSD) sufferers and compare male and female symptom profiles. Research design and methods: A total of 103 consecutive attendees at a clinic for PTSD were examined using a checklist of DSM-IV PTSD characteristics. The presence and absence of all symptoms was evaluated in a research interview. Some additional symptoms were also routinely asked about, such as mood lability, substance use, sex drive or libido. Symptom profiles of male and female sufferers of PTSD were compared using the chi-squared statistical test. Main outcome measures: Structured interview using checklist of DSM-IV PTSD characteristics. Results: Certain symptoms were present in more than 30% of sufferers. Symptom frequencies for anxiety, insomnia, distressing and recurrent dreams, flashback imagery and intrusive thoughts, irritability, poor concentration, avoidance behaviour and detachment all reached frequencies above 70%. Some symptoms (such as inability to recall parts of the trauma and restricted affect) occurred in no more than 35% of sufferers. Conclusions: Men are significantly more likely than women to suffer with irritability (p < 0.05) and to use alcohol to excess (p < 0.05). Symptoms tend to follow an acute stress reaction, occur early and persist for many months. A case is made for restricting the diagnosis to the most prevalent symptoms and for including some often overlooked symptoms in the diagnostic guidelines, namely low mood, mood lability, and impaired libido.