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Postraumatic Stress

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El síndrome de estrés postraumático (SEPT) se presenta tras la exposición súbita a una situación de estrés lo bastante intensa y prolongada como para desbordar ampliamente las capacidades de integración cognitiva emocional del sujeto.

La notoriedad y universal reconocimiento del síndrome, sin embargo, no se ha producido hasta que fue incluido en la DSM-III norteamericana, bajo la influencia de la presión social desencadenada por las severas alteraciones psiquiátricas presentadas por los veteranos de la guerra de Vietnam. Desde entonces ha quedado claro que este síndrome clínico no es exclusivo de soldados en combate, sino que también se presenta en maestros de escuelas públicas conflictivas (Bloch, 1978), víctimas de agresiones sexuales (Rose, 1986), parejas divorciadas (González de Rivera, 1990) y, por supuesto, en supervivientes de toda clase de accidentes, crímenes, atentados y desastres (Horowitz, 1981).

La décima edición de la Clasificación Internacional de Enfermedades de la O.M.S., destinada a entrar en vigor a partir de 1993, parece haber atendido a consideraciones análogas, al diferenciar todo un epígrafe para «trastornos neuróticos, somatoformes y relacionados con el estrés», en el que existe una categoría (la F43) denominada «Reacciones al estrés grave y trastornos de adaptación» en el que se engloban la Reacción a estrés agudo (F43.0), el Trastorno de Estrés Post-traumático (F43.1) y los trastornos de adaptación (F43.2). Prudentemente, se incluyen dos síndromes más: el F43.8 que corresponde a «otros» y el F43.9 a «a especificar». (APA. 1987; Sartorius, 1988).

En buen lógica médica, un síndrome se describe en base a su perfil sintomático característico, y no en relación con una clasificación discriminatoria artificial de las distintas intensidades del factor etiológico.

Desde una perspectiva individual, el factor etiológico más importante es el

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