Advancements in the Diagnosis and Treatment of War-Related Post-traumatic Stress Disorder: A Narrative Review

Abstract

Context: War-related post-traumatic stress disorder (WPTSD) is a mental health condition caused by exposure to extreme traumatic events related to war. Its core symptom cluster includes re-experiencing the traumatic event, avoidance behavior, negative changes in cognition and emotion, and increased arousal. Due to the persistence of global conflicts and the diversification of the nature of wars, the incidence rate of WPTSD is rising, affecting both military personnel and civilians in conflict areas. The WPTSD causes significant distress, impairs social functioning, and imposes a substantial burden on families and society. Therefore, we conducted a comprehensive review of the latest advancements in WPTSD research by analyzing existing reports on symptoms, diagnosis, and treatment. Evidence Acquisition: The researcher conducted a comprehensive search of all articles published from January 2004 to December 2024 in the Web of Science (core collection), PubMed/Medline, and CNKI. The search utilized the keywords “PTSD” and “War”, restricting results to articles published in Chinese or English. Results: The diagnostic criteria for WPTSD are continuously evolving. The Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition, Text Revision (DSM-5-TR), and the International Classification of Diseases, Eleventh Revision (ICD-11), have refined these criteria, emphasizing symptom diversity and core manifestations. Clinical assessment tools, such as the Clinician-Administered Post-traumatic Stress Disorder Scale (CAPS) and the post-traumatic stress disorder Checklist for DSM-5 (PCL-5), are widely used. Treatment methods, including first-line psychotherapy [trauma-focused cognitive behavioral therapy (TF-CBT), eye movement desensitization and reprocessing (EMDR), and virtual reality exposure therapy (VRET)], pharmacotherapy, and innovative approaches, have demonstrated application value in WPTSD. Significant progress has been made in the diagnosis and treatment of WPTSD; however, there remain some limitations. Conclusions: It is necessary to further enhance cross-cultural research to optimize diagnostic tools, promote the clinical application of biomarkers and neuroimaging to achieve objective diagnosis, explore multimodal combined treatments and personalized treatment models based on artificial intelligence for refractory patients, conduct long-term follow-up to develop comprehensive rehabilitation models, and strengthen military-civilian cooperation to integrate social support and vocational rehabilitation.