PTSD Awareness Day: interview with Martina Rojnic Kuzman
Friday 27 June marks PTSD Awareness Day 2025. On this occasion, we are excited to showcase the insights of Martina Rojnic Kuzman, EPA Treasurer and lead of the 2022 Ambassador Survey study on clinician treatment choices for post-traumatic stress disorder. PTSD is still highly misunderstood, and it is essential to bring light to this issue.
Discover more on the subject below, in this exclusive interview with Prof Rojnic Kuzman.
Why is it important to raise public awareness about PTSD, and what are some common misconceptions you encounter in your work?
A common misconception is that PTSD is a specific psychiatric disorder that occurs only in response to extreme traumatic events, such as war, and is treated exclusively within psychiatric settings. However, psychological trauma has been identified as a transdiagnostic risk factor for a wide range of mental and physical health conditions, particularly when it occurs repeatedly or over a prolonged period during childhood. Trauma, and disorders that may develop as a result, such as post-traumatic stress disorder, significantly increase the risk of developing various psychiatric and chronic somatic illnesses later in life.
Another widespread misconception concerns the duration of PTSD. If left untreated, or if treatment methods are ineffective, PTSD can become a chronic mental health condition. In some cases, its symptoms may even be masked by co-occurring somatic conditions, making diagnosis and treatment more complex.
What are the typical signs and symptoms of PTSD, and when should someone consider seeking professional help?
PTSD typically develops following exposure to traumatic events, either through direct experience, witnessing the event happening to others, or learning that it occurred to a close family member or friend. Traumatic events include incidents such as serious injury, physical assault, sexual violence, and others. Trauma can also result from large-scale events, whether natural disasters (e.g., earthquakes) or human-made catastrophes (e.g., war).
The diagnosis of PTSD is based on the presence of symptoms across four clusters:
- Intrusion symptoms, such as intrusive memories, recurrent distressing dreams related to the traumatic event (or frightening dreams in children), dissociative reactions such as flashbacks, or trauma-specific reenactment during play in children.
- Avoidance of stimuli associated with the trauma, including efforts to avoid distressing memories, thoughts, feelings, or external reminders.
- Negative alterations in cognition and mood, such as distorted memories of the event, persistent negative beliefs or expectations about oneself or the world, persistent negative emotional states, or feelings of detachment from others.
- Marked alterations in arousal and reactivity, including irritable or aggressive behavior, self-destructive behavior, hypervigilance, exaggerated startle response, and difficulties with sleep and concentration.
According to diagnostic classification systems (e.g., DSM-5 or ICD-11), these symptoms must persist for at least one month to meet the criteria for PTSD. However, since symptoms can emerge shortly after the traumatic event, it is important to seek professional support early.
How has the understanding and treatment of PTSD evolved in recent years, particularly in clinical psychiatry?
In recent years, a growing body of evidence has highlighted the significant role of trauma in the development of both somatic and psychiatric disorders. Research has also shed light on the mechanisms through which traumatic experiences shape the neural networks of affected individuals and may even produce transgenerational effects. In practical terms, trauma-informed interventions encompass the full spectrum of care, from prevention and early detection to treatment and rehabilitation, and are delivered across various sectors. These include informal providers of mental health support, such as teachers and community workers, primary healthcare providers, specialized mental health services, and other medical specialties managing patients with chronic physical illnesses (e.g., cardiology, gastroenterology).
What role can mental health professionals play in supporting individuals with PTSD beyond diagnosis and medication?
Mental health professionals, including psychiatrists, psychologists, social workers, and psychiatric nurses, are equipped to provide a wide range of psychotherapeutic interventions. Several of these therapies have demonstrated strong evidence for effectiveness in treating PTSD. Notable evidence-based approaches include Eye Movement Desensitization and Reprocessing (EMDR), Cognitive Behavioral Therapy (CBT), psychodynamically oriented psychotherapy, Trauma Release Exercises, among others.
Research has shown that individuals with chronic PTSD are at increased risk for a variety of somatic comorbidities, including hypertension, cerebrovascular and cardiovascular diseases, diabetes, hyperlipidemia, and cancer and tend to have a reduced overall life expectancy. Psychiatrists should offer comprehensive care for these patients which should include psychoeducation, promotion of lifestyle changes, regular screening for comorbid physical conditions, and close collaboration with other medical specialists.
Your recent study surveyed psychiatrists across 39 European countries on PTSD treatment. What insight did this bring into current practices and challenges?
In this study, we examined the therapeutic preferences of psychiatrists and psychiatry trainees working in mental health services across four European regions, using clinical case vignettes to assess their approaches to treating PTSD. The primary finding reveals a general trend across all regions: clinicians tend to favor pharmacotherapy over psychotherapy for the treatment of PTSD, despite this not being aligned with current clinical guidelines.
This pattern likely reflects disparities in resource availability rather than clinical rationale. More than 80% of respondents indicated they would prescribe antidepressants—most commonly sertraline—as their preferred pharmacological treatment. In terms of psychotherapy, over half of the clinicians recommended trauma-focused cognitive behavioral therapy, while about one-third endorsed psychoeducation, regardless of their geographic location. These differences underscore the need for increased dialogue among European national psychiatric associations and within the European Psychiatric Association (EPA) community to promote the harmonization of best practices. The EPA should prioritize strategies to support the implementation of evidence-based guidelines and encourage broader adherence among clinicians.
The full paper is available here : https://www.cambridge.org/core/journals/european-psychiatry/article/clinician-treatment-choices-for-posttraumatic-stress-disorder-ptsd-ambassadors-survey-of-psychiatrists-in-39-european-countries/C168D474337EBC8BE4827C6DD6B6B745
