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Post-traumatic stress disorder (PTSD) is a disruptive condition associated with great suffering. Fortunately, effective treatments are available. Assessment of children and adolescents with symptoms of PTSD is done within the child and adolescent mental health services. Adults are assessed in primary healthcare settings. In complex conditions with psychiatric comorbidity, assessment is conducted in specialist psychiatric services. Trauma-focused psychotherapy is the treatment of choice for both children and adults. Trauma-focused psychotherapy is also recommended for treating complex PTSD, despite a weaker evidence base. PTSD-specific treatment should normally be offered even in the presence of psychiatric comorbidities. Treatment of children and adolescents with PTSD and CPTSD is provided by child and adolescent mental health services. Adults can receive treatment both in primary and secondary healthcare settings, depending on symptomatology and comorbidities.

Post-traumatic stress disorder, PTSD, is a psychiatric diagnosis that describes a condition where one or more very traumatic events, that include life-threatening or extreme psychological stress, have left permanent traces of distress that induce sustained suffering.  In this clinical overview, we present current updates in diagnostic criteria and a new diagnosis of complex PTSD, and discuss the problems caused by the new PTSD diagnosis criteria partially differing in the DSM-5 and ICD-11 diagnostic manuals. Diagnostic challenges caused by symptom variations is discussed, as well as the high degree of comorbidity with other psychiatric and somatic illnesses. Combined forms of treatment that reduce both psychological PTSD and somatic symptoms is underscored, as well as the clinical value of early discovery of PTSD and treatment of comorbidity. Furthermore, the article illuminates knowledge about resilience and social support as protective factors.

Psychiatric treatment must be developed and adapted, as Sweden's population has become increasingly multicultural and many migrants are refugees from war and conflict areas. Methods and ways of working need to take account of cultural variation in the expression of symptoms and the fact that many refugees have experienced deeply traumatic events, such as torture and other violations of their human rights. Methods should be sensitive to patients' experiences, knowledge and social situation, and consider social determinants of health. Here we provide examples of evidence-based transcultural method development, with a particular focus upon adults and the treatment of posttraumatic stress disorder (PTSD). We also examine the cultural encounter as well as indicate areas in need of development.

The Swedish word, 'bemötande', has no direct equivalent in English but refers to contact, treatment and the relationship with a patient. 'Bemötande', in the context of care, concerns amongst other things how the session is conducted and takes place. The experience of a positive 'bemötande' is important for the patient and relatives to be able to feel trust and confidence, as well as to create a well-functioning working alliance. A respectful 'bemötande' is made more difficult by people's need to classify and see individuals as 'us' and 'them'. A positive 'bemötande' can reinforce patients' self-esteem and have an empowering effect. In this article, we discuss positive 'bemötande' in a transcultural psychiatric care context and focus, in particular, upon the vulnerable patient. We also give examples of how an organisation can contribute to good contact with the local community and facilitate the encounter with individual patients.