SHOULD THERE BE A CLINICAL TYPOLOGY OF POSTTRAUMATIC-STRESS-DISORDER

Objective: The current classification of posttraumatic stress disorder in acute, chronic and delayed-onset types is incomplete and of limite d usefulness. The present paper explores the possibilities of a clinic ally-based typology that would reflect both the patients' syndromic pr esentation and modern research findings. Method: Review of current cli nical and research literature, with a critical examination of proposed typologies, parameters utilised, applicability and relevance; elabora tion of theoretical and practical bases of a clinical typology of post traumatic stress disorder. Results: None of the existing posttraumatic stress disorder typologies presents a clinically comprehensive scope. A typology supported by literature findings and clinical observations is proposed. The six clinical types are depressive, dissociative, som atomorphic, psychotomorphic, organomorphic and 'neurotic-like'. Substa nce abuse and personality disorder-like variants remain as areas of in vestigation. Conclusions: The proposed typology, while accepting the n uclear manifestations of posttraumatic stress disorder, highlights pro minent coexisting symptoms that define the clinical appearance of diff erent patients. The typological approach in posttraumatic stress disor der does not carry the ambiguities of comorbidity, and facilitates a m ore specific and appropriate management of the cases.