[Sex and gender differences in posttraumatic stress disorder: current evidence on etiology, trajectory and treatment].

Abstract

Background: Sex and gender differences in mental disorders are widespread. Posttraumatic stress disorder (PTSD) is one of the mental disorders with the largest prevalence differences between women and men.

Aim of the paper and methods: This narrative review article highlights the current scientific evidence on sex and gender differences in the development, diagnostics and treatment of PTSD.

Results: Although men more frequently experience traumatic events women have a twofold to threefold higher risk of developing PTSD and experience more severe PTSD symptoms than men. The increased vulnerability of women is not yet fully understood and can be attributed to a combination of biological and psychosocial factors. Despite the higher risk, women and female-specific risk factors are underrepresented in relevant research, a gender data gap exists. Men are more likely to experience accidental and weapon-related trauma and women are more likely to be exposed to sexual violence. While women more frequently suffer from comorbid anxiety and affective disorders, PTSD in men occurs more frequently in combination with substance abuse. Men with PTSD are less likely to seek psychotherapeutic help than women and benefit less from evidence-based trauma-focused interventions.

Discussion: The differential consideration of biological and psychosocial factors is crucial to understanding sex and gender differences in PTSD. Sex and gender-sensitive approaches in diagnostics and treatment as well as the consideration of sex/gender beyond binary classifications can help to close knowledge gaps and enable more targeted care.