Acute and Posttraumatic Stress Disorders

Acute stress disorder and posttraumatic stress disorder (PTSD) are debilitating psychiatric conditions that may occur following traumatic events or severe stressors. Generally, these two conditions have similar diagnostic criteria, with acute stress disorder marked by symptoms for less than 1 month and PTSD with symptoms lasting 1 month or more. The exact mechanism by which PTSD develops in the brain is not known. Groups at risk for developing PTSD include women, people with low socioeconomic status, previously married people, and people younger than 65 years. Symptoms must include exposure to a stressor, intrusive thoughts or perceptions, avoidance, negative cognitions or emotions, and marked arousal and reactivity. Early treatment of acute stress disorder may prevent progression to PTSD. Treatment is primarily trauma-based psychotherapy, although medications may be used for symptom management and treating comorbid psychiatric conditions such as depression or panic attacks. Patients with PTSD should not be treated with benzodiazepines due to worsening morbidity. Treatment of PTSD limits the course of the condition and reduces comorbidities.