Acute stress disorder natural history, complications and prognosis

Jump to: navigation, search

Acute stress disorder Microchapters

Home

Patient Information

Overview

Historical Perspective

Classification

Pathophysiology

Causes

Differentiating Acute stress disorder from other Diseases

Epidemiology and Demographics

Risk Factors

Screening

Natural History, Complications and Prognosis

Diagnosis

Diagnostic Criteria

History and Symptoms

Physical Examination

Laboratory Findings

Other Imaging Findings

Other Diagnostic Studies

Treatment

Medical Therapy

Psychotherapy

Brain Stimulation Therapy

Cost-Effectiveness of Therapy

Future or Investigational Therapies

Case Studies

Case #1

Acute stress disorder natural history, complications and prognosis On the Web

Most recent articles

Most cited articles

Review articles

CME Programs

Powerpoint slides

Images

American Roentgen Ray Society Images of Acute stress disorder natural history, complications and prognosis

All Images
X-rays
Echo & Ultrasound
CT Images
MRI

Ongoing Trials at Clinical Trials.gov

US National Guidelines Clearinghouse

NICE Guidance

FDA on Acute stress disorder natural history, complications and prognosis

CDC on Acute stress disorder natural history, complications and prognosis

Acute stress disorder natural history, complications and prognosis in the news

Blogs on Acute stress disorder natural history, complications and prognosis

Directions to Hospitals Treating Acute stress disorder

Risk calculators and risk factors for Acute stress disorder natural history, complications and prognosis

Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]Associate Editor(s)-in-Chief: Simrat Sarai, M.D. [2]

Overview

If left untreated, 50% of patients with acute stress disorder may progress to develop post traumatic stress disorder. Common complications of acute stress disorder include interference with sleep, energy levels, and capacity to attend to tasks, generalized withdrawal, and progression to post traumatic stress disorder. Prognosis is generally good, and the majority of individuals experiencing acute stress disorder recover completely. If the disorder lasts more than 4 weeks, a significant percentage will develop posttraumatic stress disorder (PTSD). Of individuals who have cognitive-behavioral therapy (CBT) shortly after frightening events, only about 10% to 20% develop PTSD.

Natural History

  • In the initial days and weeks after a traumatic event, trauma survivors typically display symptoms of marked distress, but then the majority of people tend to adapt, and these symptoms remit.
  • Persons may develop an acute stress reaction, within minutes of a traumatic event. Acute stress reaction is a transient condition involving a broad array of signs and symptoms, including anxiety, depression, fatigue, difficulties with memory and concentration, hyperarousal, and social withdrawal. These occur at the same time as or within a few minutes of the traumatic event, and in majority of cases disappear within hours or days. Patients with traumatic stress often present with general symptoms, such as gastrointestinal disorders, headaches, rheumatic pain, skin disorders, cardiovascular symptoms, difficulty sleeping, or psychological problems such as anxiety and depression.[1]
  • Acute stress disorder cannot be diagnosed until 3 days after a traumatic event. Although acute stress disorder may progress to posttraumatic stress disorder (PTSD) after 1 month, it may also be a transient stress response that remits within 1 month of trauma exposure and does not result in post traumatic stress disorder (PTSD). Approximately half of individuals who eventually develop post traumatic stress disorder (PTSD) initially present with acute stress disorder. Symptom worsening during the initial month can occur, due to ongoing life stressors or further traumatic events.[2]
  • The forms of reexperiencing can vary across development. Young children may report frightening dreams without content that clearly reflects aspects of the trauma, unlike adults and adolescents. Children age 6 years and younger are more likely than older children to express reexperiencing symptoms through play that refers symbolically to the trauma. Young children also do not necessarily manifest fearful reactions at the time of the exposure to the trauma or even during reexperiencing. In young children who are traumatized, parents typically report a range of emotional expressions, such as shame, anger, or withdrawal, and even excessively bright positive affect.
  • The intent of the ASD diagnosis is to facilitate identification and treatment of acute stress responses. Treatment of ASD can have a significant benefit of limiting subsequent posttraumatic stress disorder (PTSD).

Complications

Acute Stress Disorder may interfere with sleep, energy levels, and capacity to attend to tasks. This disorder can result in generalized withdrawal from many threatening situations (e.g., medical appointments, absenteeism from work). Half of the individuals who develop Post-traumatic Stress Disorder initially present with Acute Stress Disorder. Individuals may be indifferent to maintaining their health and safety. There is a possibility of progression to posttraumatic stress disorder. Feelings of despair can be severe enough to qualify as a major depressive episode.

Prognosis

The majority of individuals experiencing acute stress disorder recover completely. If the disorder lasts more than 4 weeks, a significant percentage will develop posttraumatic stress disorder (PTSD). Of individuals who have cognitive-behavioral therapy (CBT) shortly after frightening events, only about 10% to 20% develop PTSD. Decreased functioning following previous stresses, lack of a support system, substance abuse, and the coexistence of other psychiatric disturbances can negatively affect the outcome of the disorder. Approximately between 40 and 80 percent of those with ASD develop subsequent PTSD; that is, half or more of people with ASD do not experience chronic PTSD. Only approximately 30 to 60 percent of those who eventually develop PTSD meet criteria for acute stress disorder (ASD) in the acute phase, indicating that most people who develop PTSD are not detected by the diagnosis.[3][4] [5][6][7][8][9][10][11][12][13][14][15][16][17][18][19][20][21][22][23]

References

  1. Kavan MG, Elsasser GN, Barone EJ (2012). "The physician's role in managing acute stress disorder". Am Fam Physician. 86 (7): 643–9. PMID [ 23062092 [ Check |pmid= value (help).
  2. Diagnostic and statistical manual of mental disorders : DSM-5. Washington, D.C: American Psychiatric Association, 2013. Print.
  3. Harvey AG, Bryant RA (1998). "The relationship between acute stress disorder and posttraumatic stress disorder: a prospective evaluation of motor vehicle accident survivors". J Consult Clin Psychol. 66 (3): 507–12. PMID 9642889.
  4. Brewin CR, Andrews B, Rose S, Kirk M (1999). "Acute stress disorder and posttraumatic stress disorder in victims of violent crime". Am J Psychiatry. 156 (3): 360–6. doi:10.1176/ajp.156.3.360. PMID 10080549.
  5. Bryant RA, Creamer M, O'Donnell ML, Silove D, McFarlane AC (2008). "A multisite study of the capacity of acute stress disorder diagnosis to predict posttraumatic stress disorder". J Clin Psychiatry. 69 (6): 923–9. PMID 18422396.
  6. Dalgleish T, Meiser-Stedman R, Kassam-Adams N, Ehlers A, Winston F, Smith P; et al. (2008). "Predictive validity of acute stress disorder in children and adolescents". Br J Psychiatry. 192 (5): 392–3. doi:10.1192/bjp.bp.107.040451. PMID 18450669.
  7. Kassam-Adams N, Winston FK (2004). "Predicting child PTSD: the relationship between acute stress disorder and PTSD in injured children". J Am Acad Child Adolesc Psychiatry. 43 (4): 403–11. doi:10.1097/00004583-200404000-00006. PMID 15187800.
  8. Bryant RA, Salmon K, Sinclair E, Davidson P (2007). "The relationship between acute stress disorder and posttraumatic stress disorder in injured children". J Trauma Stress. 20 (6): 1075–9. doi:10.1002/jts.20282. PMID 18157890.
  9. Bryant RA (2011). "Acute stress disorder as a predictor of posttraumatic stress disorder: a systematic review". J Clin Psychiatry. 72 (2): 233–9. doi:10.4088/JCP.09r05072blu. PMID 21208593.
  10. Bryant RA, Harvey AG (1998). "Relationship between acute stress disorder and posttraumatic stress disorder following mild traumatic brain injury". Am J Psychiatry. 155 (5): 625–9. doi:10.1176/ajp.155.5.625. PMID 9585713.
  11. Holeva, Vassiliki; Tarrier, Nicholas; Wells, Adrian (2001). "Prevalence and predictors of acute stress disorder and PTSD following road traffic accidents: Thought control strategies and social support". Behavior Therapy. 32 (1): 65–83. doi:10.1016/S0005-7894(01)80044-7. ISSN 0005-7894.
  12. Staab JP, Grieger TA, Fullerton CS, Ursano RJ (1996). "Acute stress disorder, subsequent posttraumatic stress disorder and depression after a series of typhoons". Anxiety. 2 (5): 219–25. doi:10.1002/(SICI)1522-7154(1996)2:5<219::AID-ANXI3>3.0.CO;2-H. PMID 9160626.
  13. Kangas M, Henry JL, Bryant RA (2005). "The relationship between acute stress disorder and posttraumatic stress disorder following cancer". J Consult Clin Psychol. 73 (2): 360–4. doi:10.1037/0022-006X.73.2.360. PMID 15796646.
  14. Harvey AG, Bryant RA (1999). "The relationship between acute stress disorder and posttraumatic stress disorder: a 2-year prospective evaluation". J Consult Clin Psychol. 67 (6): 985–8. PMID 10596520.
  15. Elklit A, Brink O (2004). "Acute stress disorder as a predictor of post-traumatic stress disorder in physical assault victims". J Interpers Violence. 19 (6): 709–26. doi:10.1177/0886260504263872. PMID 15140320.
  16. Hamanaka S, Asukai N, Kamijo Y, Hatta K, Kishimoto J, Miyaoka H (2006). "Acute stress disorder and posttraumatic stress disorder symptoms among patients severely injured in motor vehicle accidents in Japan". Gen Hosp Psychiatry. 28 (3): 234–41. doi:10.1016/j.genhosppsych.2006.02.007. PMID 16675367.
  17. Ginzburg K, Solomon Z, Dekel R, Bleich A (2006). "Longitudinal study of acute stress disorder, posttraumatic stress disorder and dissociation following myocardial infarction". J Nerv Ment Dis. 194 (12): 945–50. doi:10.1097/01.nmd.0000249061.65454.54. PMID 17164634.
  18. Fullerton CS, Ursano RJ, Wang L (2004). "Acute stress disorder, posttraumatic stress disorder, and depression in disaster or rescue workers". Am J Psychiatry. 161 (8): 1370–6. doi:10.1176/appi.ajp.161.8.1370. PMID 15285961.
  19. Murray J, Ehlers A, Mayou RA (2002). "Dissociation and post-traumatic stress disorder: two prospective studies of road traffic accident survivors". Br J Psychiatry. 180: 363–8. PMID 11925361.
  20. Balluffi A, Kassam-Adams N, Kazak A, Tucker M, Dominguez T, Helfaer M (2004). "Traumatic stress in parents of children admitted to the pediatric intensive care unit". Pediatr Crit Care Med. 5 (6): 547–53. doi:10.1097/01.PCC.0000137354.19807.44. PMID 15530191.
  21. Kassam-Adams N, Fleisher CL, Winston FK (2009). "Acute stress disorder and posttraumatic stress disorder in parents of injured children". J Trauma Stress. 22 (4): 294–302. doi:10.1002/jts.20424. PMID 19637323.
  22. Elklit A, Christiansen DM (2010). "ASD and PTSD in rape victims". J Interpers Violence. 25 (8): 1470–88. doi:10.1177/0886260509354587. PMID 20068117.
  23. Kühn M, Ehlert U, Rumpf HJ, Backhaus J, Hohagen F, Broocks A (2006). "Onset and maintenance of psychiatric disorders after serious accidents". Eur Arch Psychiatry Clin Neurosci. 256 (8): 497–503. doi:10.1007/s00406-006-0670-6. PMID 16917684.



Linked-in.jpg