Editing Post-traumatic stress disorder (section)

=== United States ===
PTSD affects about 5% of the US adult population each year.<ref>{{cite news |last1=Nuwer |first1=Rachel |author-link=Rachel Nuwer |title=MDMA Therapy for PTSD Inches Closer to U.S. Approval |work=The New York Times |url=https://www.nytimes.com/2023/09/14/health/mdma-ptsd-psychedelics.html |agency=New York Times |date=Sep 14, 2023}}</ref> 
The [[National Comorbidity Survey|National Comorbidity Survey Replication]] has estimated that the [[lifetime prevalence]] of PTSD among adult Americans is 6.8%, with women (9.7%) more than twice as likely as men<ref name="Olszewski 2005 40" /> (3.6%) to have PTSD at some point in their lives.<ref name=Kessler95>{{cite journal |vauthors=Kessler RC, Sonnega A, Bromet E, Hughes M, Nelson CB |title=Posttraumatic stress disorder in the National Comorbidity Survey |journal=[[Archives of General Psychiatry]] |volume=52 |issue=12 |pages=1048–60 |date=December 1995 |pmid=7492257 |doi=10.1001/archpsyc.1995.03950240066012|s2cid=14189766 }}</ref> More than 60% of men and more than 60% of women experience at least one traumatic event in their life. The most frequently reported traumatic events by men are rape, combat, and childhood neglect or physical abuse. Women most frequently report instances of rape, sexual molestation, physical attack, being threatened with a weapon and childhood physical abuse.<ref name="Olszewski 2005 40" /> 88% of men and 79% of women with lifetime PTSD have at least one [[comorbid]] psychiatric disorder. Major depressive disorder, 48% of men and 49% of women, and lifetime alcohol use disorder or dependence, 51.9% of men and 27.9% of women, are the most common comorbid disorders.<ref>{{cite journal |vauthors=Sher L |s2cid=5900319 |title=Neurobiology of suicidal behavior in post-traumatic stress disorder |journal=Expert Review of Neurotherapeutics |volume=10 |issue=8 |pages=1233–5 |date=August 2010 |pmid=20662745 |doi=10.1586/ern.10.114}}</ref>

==== Military combat ====
The [[United States Department of Veterans Affairs]] estimates that 830,000 Vietnam War veterans had symptoms of PTSD.<ref>{{cite web |vauthors=Mintz S |year=2007 |url=http://www.digitalhistory.uh.edu/database/article_display.cfm?HHID=513 |archive-url=https://web.archive.org/web/20030907033319/http://www.digitalhistory.uh.edu/database/article_display.cfm?HHID=513 |archive-date=2003-09-07 |title=The War's Costs |website=Digital History}}</ref> The ''National Vietnam Veterans' Readjustment Study'' (NVVRS) found 15% of male and 9% of female Vietnam veterans had PTSD at the time of the study. Life-time prevalence of PTSD was 31% for males and 27% for females. In a reanalysis of the NVVRS data, along with analysis of the data from the Matsunaga Vietnam Veterans Project, Schnurr, Lunney, Sengupta, and Waelde found that, contrary to the initial analysis of the NVVRS data, a large majority of Vietnam veterans had PTSD symptoms (but not the disorder itself). Four out of five reported recent symptoms when interviewed 20–25 years after Vietnam.<ref name="autogenerated2">{{cite web |vauthors=Price JL |title=Findings from the National Vietnam Veterans' Readjustment Study – Factsheet |work=United States [[Department of Veterans Affairs]] |publisher=[[National Center for PTSD]] |url=http://ncptsd.va.gov/ncmain/ncdocs/fact_shts/fs_nvvrs.html?printable-template=factsheet |archive-url=https://web.archive.org/web/20090430104839/http://www.ncptsd.va.gov/ncmain/ncdocs/fact_shts/fs_nvvrs.html |archive-date=2009-04-30}}</ref>

A 2011 study from [[Georgia State University]] and [[San Diego State University]] found that rates of PTSD diagnosis increased significantly when troops were stationed in combat zones, had tours of longer than a year, experienced combat, or were injured. Military personnel serving in combat zones were 12.1 percentage points more likely to receive a PTSD diagnosis than their active-duty counterparts in non-combat zones. Those serving more than 12 months in a combat zone were 14.3 percentage points more likely to be diagnosed with PTSD than those having served less than one year.<ref name="Journalistsresource.org">{{cite web |url=http://journalistsresource.org/studies/government/federalstate/psychological-costs-war-military-combat-mental-health/ |title=Psychological Costs of War: Military Combat and Mental Health |publisher=Journalistsresource.org |access-date=2014-01-29 |url-status=live |archive-url=https://web.archive.org/web/20140202140609/http://journalistsresource.org/studies/government/federalstate/psychological-costs-war-military-combat-mental-health/ |archive-date=2014-02-02 |date=2012-02-27}}</ref>

Experiencing an enemy firefight was associated with an 18.3 percentage point increase in the probability of PTSD, while being wounded or injured in combat was associated with a 23.9 percentage point increase in the likelihood of a PTSD diagnosis. For the 2.16&nbsp;million U.S. troops deployed in combat zones between 2001 and 2010, the total estimated two-year costs of treatment for combat-related PTSD are between $1.54&nbsp;billion and $2.69&nbsp;billion.<ref name="Journalistsresource.org"/>

As of 2013, rates of PTSD have been estimated at up to 20% for veterans returning from Iraq and Afghanistan.<ref name="VAscreen">{{cite book |vauthors=Spoont M, Arbisi P, Fu S, Greer N, Kehle-Forbes S, Meis L, Rutks I, Wilt TJ |title=Screening for Post-Traumatic Stress Disorder (PTSD) in Primary Care: A Systematic Review |date=January 2013 |pmid=23487872 |url=https://www.ncbi.nlm.nih.gov/books/NBK126691/ |publisher=[[Department of Veterans Affairs]] |series=VA Evidence-based Synthesis Program Reports}}</ref> As of 2013 13% of veterans returning from Iraq were [[unemployed]].<ref>{{Cite news |url=http://www.medscape.com/viewarticle/781380_2 |title=Mission Critical: Getting Vets With PTSD Back to Work |vauthors=Meade BJ, Glenn MK, Wirth O |date=March 29, 2013 |work=NIOSH: Workplace Safety and Health |publisher=Medscape & NIOSH |url-status=live |archive-url=https://web.archive.org/web/20160316003216/http://www.medscape.com/viewarticle/781380_2 |archive-date=March 16, 2016}}</ref>

==== Human-made disasters ====
The [[September 11 attacks]] took the lives of nearly 3,000 people, leaving 6,000 injured.<ref name="Lowell_2018">{{cite journal |vauthors=Lowell A, Suarez-Jimenez B, Helpman L, Zhu X, Durosky A, Hilburn A, Schneier F, Gross R, Neria Y |title=9/11-related PTSD among highly exposed populations: a systematic review 15 years after the attack |journal=[[Psychological Medicine]] |volume=48 |issue=4 |pages=537–553 |date=March 2018 |pmid=28805168 |pmc=5805615 |doi=10.1017/S0033291717002033}}</ref> [[Trauma and first responders|First responders]] ([[police]], [[firefighters]], and [[emergency medical technicians]]), sanitation workers, and [[volunteering|volunteers]] were all involved in the recovery efforts. The [[prevalence]] of probable PTSD in these highly exposed populations was estimated across several studies using in-person, telephone, and online [[interview]]s and [[questionnaire]]s.<ref name="Lowell_2018" /><ref name="Perrin_2007">{{cite journal |vauthors=Perrin MA, DiGrande L, Wheeler K, Thorpe L, Farfel M, Brackbill R |title=Differences in PTSD prevalence and associated risk factors among World Trade Center disaster rescue and recovery workers |journal=The American Journal of Psychiatry |volume=164 |issue=9 |pages=1385–94 |date=September 2007 |pmid=17728424 |doi=10.1176/appi.ajp.2007.06101645 |s2cid=22476443}}</ref><ref name="Stellman_2008">{{cite journal |vauthors=Stellman JM, Smith RP, Katz CL, Sharma V, Charney DS, Herbert R, Moline J, Luft BJ, Markowitz S, Udasin I, Harrison D, Baron S, Landrigan PJ, Levin SM, Southwick S |title=Enduring mental health morbidity and social function impairment in world trade center rescue, recovery, and cleanup workers: the psychological dimension of an environmental health disaster |journal=[[Environmental Health Perspectives]] |volume=116 |issue=9 |pages=1248–53 |date=September 2008 |pmid=18795171 |pmc=2535630 |doi=10.1289/ehp.11164|bibcode=2008EnvHP.116.1248S }}</ref> Overall prevalence of PTSD was highest immediately following the attacks and decreased over time. However, disparities were found among the different types of recovery workers.<ref name="Lowell_2018" /><ref name="Perrin_2007" /> The rate of probable PTSD for first responders was lowest directly after the attacks and increased from ranges of 4.8–7.8% to 7.4–16.5% between the 5–6 year follow-up and a later assessment.<ref name="Lowell_2018" />

When comparing traditional responders to non-traditional responders (volunteers), the probable PTSD prevalence 2.5 years after the initial visit was greater in volunteers with estimates of 11.7% and 17.2% respectively.<ref name="Lowell_2018" /> Volunteer participation in tasks atypical to the defined occupational role was a significant risk factor for PTSD.<ref name="Perrin_2007" /> Other risk factors included exposure intensity, earlier start date, duration of time spent on site, and constant, negative reminders of the trauma.<ref name="Lowell_2018" /><ref name="Perrin_2007" />

Additional research has been performed to understand the social consequences of the September 11 attacks. Alcohol consumption was assessed in a cohort of [[World Trade Center (1973–2001)|World Trade Center]] workers using the [[CAGE questionnaire|cut-annoyed-guilty-eye (CAGE) questionnaire]] for [[alcohol use disorder]]. Almost 50% of World Trade Center workers who self-identified as alcohol users reported drinking more during the rescue efforts.<ref name="Stellman_2008" /> Nearly a quarter of these individuals reported drinking more following the recovery.<ref name="Stellman_2008" /> If determined to have probable PTSD status, the risk of developing an alcohol problem was double compared to those without psychological [[morbidity]].<ref name="Stellman_2008" /> Social disability was also studied in this cohort as a social consequence of the September 11 attacks. Defined by the disruption of family, work, and social life, the risk of developing social disability increased 17-fold when categorized as having probable PTSD.<ref name="Stellman_2008" />