BACKGROUND: Considering the recently growing number of potentially traumatic events in Europe, the European Psychiatric Association undertook a study to investigate clinicians' treatment choices for post-traumatic stress disorder (PTSD). METHODS: The case-based analysis included 611 participants, who correctly classified the vignette as a case of PTSD, from Central/ Eastern Europe (CEE) (n = 279), Southern Europe (SE) (n = 92), Northern Europe (NE) (n = 92), and Western Europe (WE) (N = 148). RESULTS: About 82% woulduse antidepressants (sertraline being the most preferred one). Benzodiazepines and antipsychotics were significantly more frequently recommended by participants from CEE (33 and 4%, respectively), compared to participants from NE (11 and 0%) and SE (9% and 3%). About 52% of clinicians recommended trauma-focused cognitive behavior therapy and 35% psychoeducation, irrespective of their origin. In the latent class analysis, we identified four distinct "profiles" of clinicians. In Class 1 (N = 367), psychiatrists would less often recommend any antidepressants. In Class 2 (N = 51), clinicians would recommend trazodone and prolonged exposure therapy. In Class 3 (N = 65), they propose mirtazapine and eye movement desensitization reprocessing therapy. In Class 4 (N = 128), clinicians propose different types of medications and cognitive processing therapy. About 50.1% of participants in each region stated they do not adhere to recognized treatment guidelines. CONCLUSIONS: Clinicians' decisions for PTSD are broadly similar among European psychiatrists, but regional differences suggest the need for more dialogue and education to harmonize practice across Europe and promote the use of guidelines.

3rd School of Medicine Charles University Prague Czech Republic

Abarbanel Mental Health Center Tel Aviv Israel

Affective Disorders Unit Department of Psychiatry Ege University Medicine Faculty Izmir Turkey

Centro de Investigação Interdisciplinar em Saúde Universidade Católica Portuguesa Lisbon Portugal

Clinic for Psychiatry University of Kragujevac Kragujevac Serbia

Clinical Department National Institute of Mental Health Klecany Czechia

CMME GHU Paris Psychiatrie et Neurosciences Hôpital Sainte Anne Paris France

Collaborative Antwerp Psychiatric Research Institute Antwerp Belgium

Community Mental Health Center Health Center Prijedor Prijedor Bosnia and Herzegovina

Department of Adult Psychiatry Mater Misericordiae University Hospital Dublin Ireland

Department of Child and Adolescent Psychiatry Institute of Psychiatry and Mental Health Hospital General Universitario Gregorio Marañón Instituto de Investigación Sanitaria Gregorio Marañón CIBERSAM ISCIII School of Medicine Universidad Complutense Madrid Spain

Department of Emergency Psychiatry and Post Acute Care Hôspital Lapeyronie CHU Montpellier Montpellier France

Department of Mental Health Medical Psychology and Psychotherapy Nicolae Testemitanu State University of Medicine and Pharmacy of the Republic of Moldova Kishinev Moldova

Department of Psychiatry and Addiction Saint Petersburg State University Saint Petersburg Russia

Department of Psychiatry and Medical Psychology Belarusian State Medical University Minsk Belarus

Department of Psychiatry and Narcology Riga Stradiņš University Riga Centre of Psychiatry and Narcology Riga Latvia

Department of Psychiatry and Psychological Medicine University Hospital Centre Zagreb and School of Medicine University of Zagreb Zagreb Croatia

Department of Psychiatry and Psychotherapy University Hospital Ludwig Maximilian University Munich Germany

Department of Psychiatry Faculty of Medicine Comenius University Bratislava Bratislava Slovakia

Department of Psychiatry Hacettepe University Faculty of Medicine Ankara Turkey

Department of Psychiatry Helsinki University Central Hospital Helsinki Finland

Department of Psychiatry Slovak Medical University Bratislava Slovakia

Department of Psychiatry Tbilisi State Medical University Tbilisi Georgia

Department of Psychiatry University of Campania L Vanvitelli Naples Italy

Faculdade de Medicina Universidade Católica Portuguesa Lisbon Portugal

Faculdade de Medicina Universidade de Lisboa Lisbon Portugal

Faculty of Psychology University of Barcelona Barcelona Spain

Great Yarmouth Acute Service Northgate Hospital Norfolk and Suffolk NHS Foundation Trust Great Yarmouth UK

Institute of Neurology Psychiatry and Narcology National Academy of Medical Sciences of Ukraine Kharkiv Ukraine

Iuliu Hatieganu University of Medicine and Pharmacy Cluj Napoca Romania

MentAge Counsil Practice Research Basel Switzerland

Mental Health Institute Hospital del Mar and Hospital del Mar Research Institute Barcelona CIBERSAM Barcelona Spain

Pomeranian Medical University in Szczecin Szczecin Poland

Psychiatric Clinic Lithuanian Health Sciences University Kaunas Hospital Kaunas Lithuania

Psychiatric University Clinic of Charité at St Hedwig Hospital Berlin Berlin Germany

Psychiatry and Department of Adult Psychiatry Collegium Medicum Jagiellonian University Cracow Poland

Psychiatry and Mental Health Department Hospital Beatriz Ângelo Loures Portugal

Psychiatry Clinic University Clinical Hospital Mostar Mostar Bosnia and Herzegovina

Research Unit Dr Mirko Grmek Psychiatric Clinic Sveti Ivan Zagreb Croatia

Roosevelt Teaching Hospital Banská Bystrica Slovakia

Royal College of Psychiatrists London UK

Semmelweis University Budapest Hungary

Special Psychiatric Hospital Kotor Kotor Montenegro

Swiss Society for Psychiatry and Psychotherapy Switzerland

The National Mental Health Center Baku Azerbaijan

Universitat Pompeu Fabra Barcelona Spain

Université Paris Cité INSERM UMR1266 Paris France

University Clinic of Psychiatry Faculty of Medicine Ss Cyril and Methodius University in Skopje Skopje Republic of North Macedonia

University of Cagliari and Psychiatry Unit Section of Psychiatry Department of Medical Sciences and Public Health University Hospital Cagliari Italy

University Psychiatric Clinic Ljubljana Slovenia

Vrapče Psychiatric University Clinic Zagreb Croatia

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