What is it about?
This study traces descriptions of psychological suffering after traumatic events across four thousand years of human history, from ancient Mesopotamian texts to modern psychiatric manuals. By comparing symptoms recorded in literary, medical and historical sources with today's diagnostic criteria for post-traumatic stress disorder (PTSD), the analysis shows that core reactions to trauma, such as nightmares, avoidance, emotional numbing and heightened alertness, have remained remarkably consistent across cultures and centuries, even as explanations shifted from divine punishment to neurobiological models.
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Why is it important?
This work is the first systematic phenomenological mapping of trauma-related symptoms across four millennia using both DSM-5-TR and ICD-11 criteria as heuristic lenses. It demonstrates that PTSD is not merely a modern diagnostic invention but reflects a recurring human response to extreme events, challenging purely constructionist views. At a time when the DSM and ICD systems are diverging in how they define PTSD, this historical perspective reframes their differences as complementary rather than competing, offering clinicians a practical rationale for integrating both frameworks. The study also highlights how historical errors, stigmatisation, coercive treatments, denial driven by economic interests, remain cautionary lessons for current policy and clinical practice.
Perspectives
As a psychiatrist working with trauma survivors, I have often noticed how patients' shame and self-blame diminish when they learn that their symptoms have been described for millennia. This observation motivated me to undertake a rigorous historical analysis rather than relying on anecdotal references. The most striking finding was the consistency of symptom clusters across radically different cultural frameworks, suggesting that what we call PTSD taps into a deeply conserved neurobiological response. I hope this "archaeology of trauma" will encourage clinicians to use history as a psychoeducational tool to normalise suffering, and will remind the field to remain vigilant against the re-stigmatisation that has historically accompanied each era's failure to recognise trauma for what it is.
Walter Paganin
Read the Original
This page is a summary of: Core symptoms of PTSD across four millennia: a phenomenological and nosographic analysis – from ancient Mesopotamian texts to modern psychiatric classifications, Medical Humanities, April 2026, BMJ,
DOI: 10.1136/medhum-2025-013623.
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