PTSD clinical-practice guideline registry¶
Last curated: 2026-09-02
Method. Issuing-body pages were fetched live on 2026-09-02 by the build session and re-checked by the audit session on the same date; where a site could not be reached on re-check this is stated explicitly in the per-guideline notes, and the document is anchored to a PubMed-indexed record wherever one exists. PubMed-indexed supporting papers use only PMIDs retrieved in this session. This registry catalogs documents; recommendation synthesis is in guidelines.md.
Master table¶
| Body | Year | Region | Scope | Citation / URL | Status |
|---|---|---|---|---|---|
| VA/DoD | 2023 | USA | Adult PTSD and acute stress disorder in VA/DoD systems | Schnurr PP, et al. Ann Intern Med. 2024;177(3):363-374. PMID 38408360; https://www.healthquality.va.gov/HEALTHQUALITY/guidelines/MH/ptsd/index.asp | current |
| American Psychological Association | 2025 | USA | Adult PTSD treatment | https://www.apa.org/about/offices/directorates/guidelines/clinical-practice | current; supersedes 2017 |
| NICE NG116 | 2018; surveillance 2025 and 2026 | UK | Recognition, assessment and treatment across ages | https://www.nice.org.uk/guidance/NG116 (re-fetched 2026-09-02) | current; supersedes CG26 (2005) |
| ISTSS | 2018 | International | Prevention and treatment; adults and children | https://istss.org/clinical-resources/trauma-treatment/ | current |
| Phoenix Australia | 2020; chapter currency 2021 | Australia | ASD, PTSD and CPTSD prevention/treatment | https://www.phoenixaustralia.org/australian-guidelines-for-ptsd/ | current; RANZCP-endorsed |
| RANZCP | 2020 | Australia/New Zealand | Endorsement of Phoenix guideline | https://www.ranzcp.org/clinical-guidelines-publications/clinical-guidelines-publications-library/post-traumatic-stress-disorder-endorsed-guidelines | current endorsement |
| WHO | 2013 | Global | Conditions specifically related to stress; mhGAP | https://www.who.int/publications-detail-redirect/9789241505406 | current document; update status to watch |
| VA/DoD | 2017 | USA | PTSD and acute stress disorder | https://www.govinfo.gov/app/details/GOVPUB-VA-PURL-gpo115018 | superseded by → VA/DoD 2023 |
| APA | 2017 | USA | Adult PTSD treatment | https://www.apa.org/ptsd-guideline/ | superseded by → APA 2025 |
| NICE CG26 | 2005 | UK | PTSD recognition and treatment | NICE archive | superseded by → NG116 (2018) |
Per-guideline notes¶
VA/DoD 2023¶
- The peer-reviewed synopsis reports 34 recommendations across five topic areas (assessment and diagnosis, prevention, treatment, treatment of nightmares, treatment of post-traumatic sleep disturbance), developed from 12 key questions using PICOTS searching and GRADE (Schnurr 2024, PMID 38408360); a companion clinician's guide describes the accompanying clinical algorithm (Lang 2024, PMID 38184799).
- Re-verification note (audit, 2026-09-02). The VA healthquality.va.gov page did not resolve from this session's network (TLS/connection failure), so the guideline is anchored here to its PubMed-indexed synopsis rather than to the issuing-body page alone.
- The update applied GRADE more rigorously and evaluated named trauma-focused therapies separately rather than only as a class.
- Population is adults eligible for VA/DoD care; civilian transportability remains empirical.
APA 2025¶
- Approved as APA policy on 22 February 2025, replacing the 2017 guideline.
- Issuing material retains trauma-focused cognitive and behavioral interventions as central and distinguishes strength of recommendation.
- Do not confuse the American Psychological Association guideline with the American Psychiatric Association legacy guideline.
NICE NG116¶
- Published 5 December 2018; covers children, young people, adults and complex needs. Confirmed by live re-fetch of https://www.nice.org.uk/guidance/NG116 on 2026-09-02.
- Replaced CG26 (2005). NICE’s 8 April 2025 surveillance found no evidence requiring changed recommendations.
- New since the build (audit, 2026-09-02): the NG116 evidence page also lists a July 2026 exceptional surveillance of NG116 together with the autism (CG142, CG170) and ADHD (NG87) guidelines. The surveillance decision document returned HTTP 403 from this session, so its outcome is recorded as unresolved, not as "no change". Highest-priority item for the next sweep.
- Pharmacological interventions for children are covered by a separate NICE evidence review (National Guideline Alliance 2018, PMID 32757557); adult drug recommendations do not transfer to it.
ISTSS 2018¶
- Development page reports 361 RCTs, 208 meta-analyses and 125 recommendations: 8 strong, 8 standard, 5 low-effect, 26 emerging and 78 insufficient-evidence. Re-verification note (audit, 2026-09-02): the ISTSS page returned HTTP 200 on re-fetch but renders its content client-side, so these counts could not be read from the raw HTML and are not independently re-confirmed; they remain as recorded by the build session. The systematic reviews underpinning the 2018 ISTSS guidelines are collected in a PubMed-indexed series introduction (Bisson 2021, PMID 34992739).
- Includes prevention/early treatment and PTSD/CPTSD position work.
Phoenix Australia 2020¶
- Covers prevention and treatment of acute stress disorder, PTSD and CPTSD.
- RANZCP formally endorses it; a December 2021 chapter update added comorbid PTSD and alternative delivery categories.
WHO 2013¶
- Global mhGAP-oriented guidance for acute stress symptoms, PTSD and bereavement.
- Its broad stress-conditions scope must not be treated as a PTSD-only evidence synthesis.
Disagreements and gaps¶
| Topic | Convergence | Material divergence or gap |
|---|---|---|
| First-line care | Trauma-focused psychotherapy is consistently central (Lewis 2020, PMID 32284821) | Named therapies and recommendation strength differ with GRADE rules and evidence cut dates |
| Medication | Sertraline/paroxetine have US approval; guidelines allow selected antidepressants | Relative ranking versus psychotherapy and strength vary; long-term evidence is thin |
| Prazosin | Nightmare symptoms may justify targeted consideration | Small positive trials conflict with the 304-person null trial (Raskind 2018, PMID 29414272) |
| CPTSD | Recognition of complex presentations is increasing | No consensus that all CPTSD requires a fixed stabilisation phase before trauma work |
| Early intervention | Universal single-session debriefing is not supported (Rose 2002, PMID 12076399) | Risk thresholds, timing and scalable stepped care remain unsettled |
| Children | Trauma-focused treatment is supported (Hoppen 2025, PMID 39630422) | Long-term comparative evidence and medication guidance are limited |
| Adverse events | All endorse clinical judgment and monitoring | Psychotherapy trials often omit systematic adverse-event data (Cusack 2016, PMID 26574151) |
| Patient preference | Shared decision-making is endorsed | Few guidelines quantify preference-sensitive trade-offs or treatment burden |
Watch list¶
| Item | Why it may change | Source to monitor |
|---|---|---|
| Additional MDMA phase 3 program | FDA rejection required another phase 3 trial (Wolfgang 2025, PMID 39741438) | FDA; ClinicalTrials.gov; PubMed |
| NICE NG116 surveillance | Current recommendations were retained in 2025 | NICE history/surveillance page |
| VA/DoD implementation evidence | 2023 guideline is being operationalized across a large system | VA National Center for PTSD |
| APA 2025 dissemination | Newly approved guideline may generate implementation tools and corrections | APA guideline page |
| WHO stress guideline | 2013 document predates ICD-11 CPTSD implementation | WHO mhGAP |
| Phoenix living updates | December 2021 chapter update shows living-guideline behaviour | Phoenix Australia / MAGICapp |
| Pediatric long-term evidence | 2025 NMA found a thinner evidence base beyond TF-CBT | PubMed query; PMID 39630422 |
Non-journal URLs above were retrieved from the issuing body or official endorser on 2026-09-02.