Post-traumatic stress disorder — master index¶
Last curated: 2026-09-02 (built by Codex, independently audited by Claude the same day) · 21 curated + 1 draft wiki pages · 385 unique PMID-verified papers (345 from the build, 40 added at audit; all 385 re-fetched and metadata-checked) · 6 landmark notes · 10 guideline records · 15 NCT records live-verified · 9 organizations listed, 7 re-fetched successfully at audit · 17 open questions + 20 unconnected-dot junctions
The condition in five sentences. PTSD is a trauma- and stressor-related disorder defined by a qualifying exposure, a patterned syndrome, persistence and impairment—not by trauma exposure alone. DSM-5 and ICD-11 identify overlapping but non-identical cases, and ICD-11 adds complex PTSD, leaving a live transportability problem for trials built under DSM definitions (Cloitre 2018, PMID 30178492). Trauma-focused CBT variants and EMDR have the strongest comparative evidence, but active-comparator differences, dropout and long-term function are less certain than waitlist-referenced symptom effects (Mavranezouli 2020, PMID 32063234; McLean 2022, PMID 34954460). Medication evidence is narrower — SSRIs improve response versus placebo (RR 0.66, 95% CI 0.59–0.74) but only sertraline and paroxetine are FDA-approved — and prazosin illustrates unresolved heterogeneity, because three positive trials and two meta-analyses favouring it sit alongside a 304-person null re-test (Williams 2022, PMID 35234292; Raskind 2018, PMID 29414272; Yücel 2020, PMID 31855732). MDMA-assisted therapy produced two positive phase 3 trials, but the FDA declined approval in August 2024 and required another phase 3 trial, so efficacy, safety, blinding and regulation remain separate questions (Mitchell 2021, PMID 33972795; Mitchell 2023, PMID 37709999; Morland 2026, PMID 41820235).
Start here: overview. Research frontier: OPEN-QUESTIONS.md. Growth history: LOG.md.
Scope and pooling rule¶
- PTSD owns the disorder, not trauma exposure in general.
- PTSD and generalized anxiety disorder are neighbours, not subsets. Mixed-anxiety estimates are labelled and only PTSD strata are used as PTSD effects.
- Comorbid depression is cross-linked rather than absorbed.
- Complex PTSD is in scope as an ICD-11 sibling diagnosis and unresolved treatment-transport problem.
Reading paths¶
- Clinical: overview → diagnosis → comparative psychotherapy → pharmacotherapy → guidelines → safety
- Therapy: prolonged exposure → cognitive processing therapy → EMDR → dropout/nonresponse
- Science: epidemiology/risk → neurobiology → complex PTSD → comorbidity
- Populations: military/veterans → children/adolescents → patient experience
- Frontier: open questions → MDMA/psychedelics → trials landscape
Wiki pages¶
| Section | Page | Scope | Status |
|---|---|---|---|
| Overview | overview.md | Post-traumatic stress disorder — Overview | curated |
| Diagnosis | diagnosis-and-classification.md | PTSD — Diagnosis and classification | curated |
| Complex-Ptsd | complex-ptsd.md | Complex PTSD | curated |
| Epidemiology | epidemiology-and-risk.md | PTSD — Epidemiology and risk | curated |
| Neurobiology | neurobiology-and-mechanism.md | PTSD — Neurobiology and mechanism | curated |
| Prolonged-Exposure | prolonged-exposure.md | Prolonged exposure for PTSD | curated |
| Cognitive-Processing-Therapy | cognitive-processing-therapy.md | Cognitive processing therapy for PTSD | curated |
| Emdr | emdr.md | Eye movement desensitization and reprocessing | curated |
| Psychotherapy | comparative-psychotherapy-evidence.md | PTSD — Comparative psychotherapy evidence | curated |
| Dropout | dropout-and-nonresponse.md | PTSD treatment dropout and nonresponse | curated |
| Pharmacotherapy | pharmacotherapy.md | PTSD pharmacotherapy | curated |
| Sleep | sleep-and-nightmare-treatment.md | PTSD sleep and nightmare treatment | curated |
| Mdma | mdma-and-psychedelic-assisted-therapy.md | MDMA and psychedelic-assisted therapy for PTSD | curated |
| Prevention | early-intervention-and-prevention.md | PTSD early intervention and prevention | curated |
| Military | military-and-veteran-populations.md | PTSD in military and veteran populations | curated |
| Children | children-and-adolescents.md | PTSD in children and adolescents | curated |
| Comorbidity | comorbidity.md | PTSD comorbidity | curated |
| Moral-Injury | moral-injury.md | Moral injury and PTSD | curated |
| Guidelines | guidelines.md | PTSD clinical practice guidelines | draft — see audit note |
| Safety | red-flags-and-safety-concerns.md | PTSD red flags and safety concerns | curated |
| Patient-Experience | patient-experience-and-advocacy.md | PTSD patient experience and advocacy | curated |
| Clinical-Trials | clinical-trials-landscape.md | PTSD clinical trials landscape | curated |
Literature layer¶
| Artifact | Contents | Status |
|---|---|---|
| BIBLIOGRAPHY.md | 345 unique live-retrieved PubMed records; tags and cited-by index | curated |
| notes/ | 6 landmark deep notes | curated |
| guidelines/REGISTRY.md | Current and superseded international guidance; disagreements and watch list | curated |
| statistics/STATISTICS.md | Definition-preserving quantitative reference tables | curated |
| patient-voice/ | Ethics/method, 9 organizations, 10 themes, annotated sources | curated |
Curation state¶
The 22 pages were written by Codex from live PubMed E-utilities and ClinicalTrials.gov v2 queries on 2026-09-02, then independently audited by Claude on the same date. No model audited its own writing.
The audit re-fetched all 385 PMIDs and 15 NCT IDs live, checked 659 reference lines, 655 evidence-ledger rows and every claim-to-citation pair on every page, re-ran the searches behind each asserted absence, and fixed what was wrong rather than only reporting it. 21 pages passed and are now status: curated.
guidelines.md remains draft for one specific reason: three of its load-bearing facts rest on issuing-body web pages rather than PubMed records, and those could not be independently re-fetched from the audit session — healthquality.va.gov failed at the TLS layer, and istss.org returned its content client-side so the 361-RCT/208-meta-analysis/125-recommendation counts could not be read from the raw HTML. The VA/DoD guideline has since been re-anchored to its peer-reviewed synopsis (Schnurr 2024, PMID 38408360), which independently confirms the 34-recommendation figure. Separately, NICE's NG116 evidence page lists a July 2026 exceptional surveillance whose decision document returned HTTP 403; until its outcome is known, describing NG116 as unchanged since April 2025 would be an assumption rather than a finding. That is the first item for the next sweep.