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PTSD clinical-practice guideline registry¶
Last curated: 2026-10-16 (issuing-body re-check and German guideline added)
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 (no update) | UK | Recognition, assessment and treatment across ages | https://www.nice.org.uk/guidance/NG116 (re-fetched 2026-09-02 and 2026-10-09) | current; supersedes CG26 (2005) |
| ISTSS | 2018 | International | Prevention and treatment; adults and children | https://istss.org/clinical-resources/trauma-treatment/; Bisson JI, et al. J Trauma Stress. 2019;32(4):475-483. PMID 31283056 | 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 |
| DeGPT / AWMF 155-001 | 2026, version 7.0 | Germany / German-speaking societies | S3 PTSD guideline; includes children/adolescents and populations with additional needs | https://www.awmf.org/aktuelles/awmf-aktuell/posttraumatische-belastungsstoerung-adapt-1 | current; dated 2026-02-27, published 2026-05-22, valid through 2031-02-26 |
| 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.
- Resolved (sweep, 2026-10-09): the surveillance page was retrieved live (https://www.nice.org.uk/guidance/ng116/evidence → July 2026 exceptional surveillance, accessed 2026-10-09). Its scope was "adapted trauma-focused treatment for autistic people and people with attention deficit hyperactivity disorder (ADHD)". Decision, verbatim: "We will not update any of the NICE guidelines." The evidence was judged "limited, indirect and of low certainty". NG116 is unchanged. The page was last updated 23 July 2026. The PDF version returned HTTP 400 and was not needed, because the decision is stated on the HTML page.
- 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. Resolved (sweep, 2026-10-09): every count, including the 8/8/5/26/78 split and the 101 adult / 24 child division, is confirmed by the PubMed-indexed methodology paper (Bisson 2019, PMID 31283056; no Crossref retraction or update). An istss.org guideline URL returned HTTP 403 on 2026-10-09. 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.
Issuing-body re-check, 2026-10-16¶
- ISTSS: the official guideline page is now readable and announces a forthcoming update. No new recommendation document was supplied on the retrieved page; monitor the release rather than treating the announcement as guidance (ISTSS — "ISTSS Prevention and Treatment Guidelines", https://istss.org/clinical-resources/trauma-treatment/istss-prevention-and-treatment-guidelines/, accessed 2026-10-16).
- DeGPT / AWMF: version 7.0 was missing from this registry. The issuing-body notice verifies the version, dates, validity and expanded population scope; detailed recommendation synthesis is deferred until the guideline is reviewed (AWMF — "Posttraumatische Belastungsstörung (ADAPT)", https://www.awmf.org/aktuelles/awmf-aktuell/posttraumatische-belastungsstoerung-adapt-1, accessed 2026-10-16). Its May publication predates the requested search window.
- VA/DoD: the previously inaccessible official page was retrieved directly and still presents the 2023 full guideline and tools (VA/DoD — "Management of Posttraumatic Stress Disorder and Acute Stress Disorder 2023", https://www.healthquality.va.gov/guidelines/MH/ptsd/, accessed 2026-10-16).
- Phoenix Australia / RANZCP: both pages were readable; Phoenix still lists the June 2020 approval and December 2021 update, and RANZCP still endorses that guideline. No later approval was displayed on these pages (Phoenix Australia — "Australian PTSD Guidelines", https://www.phoenixaustralia.org/australian-guidelines-for-ptsd/; RANZCP — "Post-traumatic stress disorder", https://www.ranzcp.org/clinical-guidelines-publications/clinical-guidelines-publications-library/post-traumatic-stress-disorder-endorsed-guidelines; accessed 2026-10-16).
- WHO: the 2013 stress-guideline landing page was retrieved; this verifies that document, not the absence of newer recommendations elsewhere in mhGAP (WHO — "WHO guidelines on conditions specifically related to stress", https://www.who.int/publications/i/item/9789241505406, accessed 2026-10-16).
- NICE / APA: NICE's evidence index was retrieved directly and still lists July 2026 exceptional surveillance as the latest entry. APA's search-indexed official page identifies its 2025 guideline; direct retrieval returned an Incapsula block. No full APA re-verification is claimed (NICE — "Evidence: Post-traumatic stress disorder", https://www.nice.org.uk/guidance/ng116/evidence; APA — "Clinical Practice Guideline for the Treatment of Posttraumatic Stress Disorder (PTSD) in Adults", https://www.apa.org/ptsd-guideline/index; accessed/search-result verified 2026-10-16, respectively).
Issuing-body re-check, 2026-10-23¶
Landing pages only. No recommendation text was re-synthesised.
- NICE: the NG116 overview and the evidence index both returned HTTP 200. The evidence index still lists the July 2026 exceptional surveillance report above the April 2025 surveillance report (NICE — "Evidence: Post-traumatic stress disorder", https://www.nice.org.uk/guidance/ng116/evidence, accessed 2026-10-23). The July 2026 decision document was not re-opened, so this sweep does not newly confirm that decision's conclusion.
- VA/DoD: the guideline page returned HTTP 200 and the title is still "Management of Posttraumatic Stress Disorder and Acute Stress Disorder 2023" (VA/DoD — "Management of Posttraumatic Stress Disorder and Acute Stress Disorder 2023", https://www.healthquality.va.gov/guidelines/MH/ptsd/, accessed 2026-10-23).
- WHO: the 2013 stress-guideline landing page returned HTTP 200. This is that document, not an mhGAP re-review (WHO — "WHO guidelines on conditions specifically related to stress", https://www.who.int/publications/i/item/9789241505406, accessed 2026-10-23).
- DeGPT / AWMF: the notice page returned HTTP 200 and still states version 7.0, register number 155-001, published 22 May 2026, stand 27 February 2026, valid until 26 February 2031 (AWMF — "Posttraumatische Belastungsstörung (ADAPT)", https://www.awmf.org/aktuelles/awmf-aktuell/posttraumatische-belastungsstoerung-adapt-1, accessed 2026-10-23). The register detail page returned a title and almost no body. Recommendation wording was not reviewed. A 22 October 2026 AWMF statement on the same page concerns a different quality-criteria draft (LOPS-RL V5), not this PTSD guideline.
- RANZCP: the endorsement page returned HTTP 200. The extracted text did not show a new approval date (RANZCP — "Post-traumatic stress disorder", https://www.ranzcp.org/clinical-guidelines-publications/clinical-guidelines-publications-library/post-traumatic-stress-disorder-endorsed-guidelines, accessed 2026-10-23).
- ISTSS: the guideline URL returned HTTP 403. The trauma-treatment landing page returned HTTP 200 and is site navigation, not a recommendation document. The forthcoming-update announcement from 2026-10-16 was not re-read (ISTSS — "ISTSS Prevention and Treatment Guidelines", https://istss.org/clinical-resources/trauma-treatment/istss-prevention-and-treatment-guidelines/, accessed 2026-10-23).
- Phoenix Australia: HTTP 403. No living-update check was completed.
- APA: https://www.apa.org/ptsd-guideline returned HTTP 200 with an empty title and body in this session's fetch. No full re-verification is claimed.
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, and the July 2026 exceptional surveillance (adapted treatment for autistic people and ADHD) decided on no update. The evidence index still listed that July 2026 report as the latest entry on 2026-10-23; the decision document was not re-opened | NICE evidence page, accessed 2026-10-23 |
| 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.