Overview

• DSM V → acute stress reaction that occurs in the first 4 weeks after a person has been exposed to a traumatic event.
  • Onset of symptoms within mintues + clear link between trauma and symptoms.
  • Must last for at least 3 days, but no more than 4 weeks. PTSD is diagnosed after >4 weeks.

Making Diagnosis

Clinical Features

• Intrusive re-experiencing of the event → flashbacks, nightmares.
• Dissociation → ‘being in a daze’, time slowing.
  • Derealisation → feeling of being in a dream state.
  • Depersonalisation → sensation of watching yourself from outside your body.
• Avoidance.
• Negative mood.
• Hyperarousal and sleep disturbance.

Investigations

Management Plan

• Support and Reassurance.
• CBT.
• Benzodiazepines → may alleviate short-term agitation.

Complications → may progress to PTSD. If formal, immediate, psychological ‘debriefing’ is undertaken, future PTSD risk is increased.