Current RMA Instruments:

Changes from previous Instruments:

SOP Bulletin 177

ICD Coding:

• ICD-9-CM: 309.81
• ICD-10-AM: F43.1

Brief description:

PTSD is a psychiatric disorder that is a reaction to being exposed to a perceived significant psychological trauma. This disorder can follow on from acute stress disorder, or uncommonly, the onset can be delayed until some time after the original trauma.

Confirming the diagnosis:

This diagnosis requires a report from a specialist psychiatrist that conforms with the Repatriation Commission Guidelines for Psychiatric Compensation Claims.

Additional diagnoses covered by these SOPs

• Nil

Historic diagnoses that may be covered by these SOPs

• Battle fatigue
• Shell shock
• War or combat neurosis

Conditions not covered by these SOPs

• Acute stress disorder*
• Adjustment disorder*
• Anxiety disorder*
• Chronic multisymptom illness*
• Somatoform disorder*

*another SOP applies

Clinical onset

Onset of PTSD may be immediate, or close in time to any causative traumatic event, or, in a small proportion of cases, may be delayed (by months or years).  The diagnostic criteria need to be fulfilled for one month before the diagnosis can be confirmed (onset would then be, retrospectively, at the start of that one month period).  Symptoms lasting for less than one month may be diagnosed as acute stress disorder.

For delayed onset PTSD, or for any psychiatric condition that has diagnostic criteria, the clinical onset will be when the required criteria were first fulfilled, which may be some time after relevant symptoms first developed - i.e., if initially some PTSD symptoms were present, but they were insufficient to meet the diagnostic criteria, then PTSD had not had its clinical onset at that point.  It is only once the symptoms fulfil the criteria (and persist for at least one month) that onset has occurred.

Clinical worsening

PTSD can spontaneously resolve, continue as a persistent disorder, or fluctuate with a variable pattern of remissions and relapses.  A range of treatment options are available and the effectiveness of treatment varies between types and between individuals.