Post-traumatic stress disorder and acute stress disorder

Situations that induce post-traumatic stress disorder and acute stress disorder are typically events that have resulted in death or threatened death, or serious injury or threat to one's own or others' physical integrity, and include accidents of considerable entity (automotive, at work), assaults, kidnappings, natural disasters, war, diagnosis of serious illnesses. Sometimes the trauma can affect other people and the person who gets sick is simply the spectator of the event ( deaths or injuries or serious illnesses, especially if related to family members or friends). However, we must keep in mind that the extent of the event is always very subjective, since some individuals develop symptoms even in the face of an event that is not particularly significant in itself.

The prevalence of post-traumatic stress disorder is about 2% but, if we consider all the forms that do not come to the attention of doctors, the prevalence rises up to 10%. The most affected subjects are young adults.

It is characterized by a set of symptoms that develop after the subject has experienced an extremely traumatic event. He reacts to this experience with fear and a sense of helplessness and tries not to remember it; however, the event is relived several times. The consequence of the trauma is to relive the event through intrusive memories that include images, thoughts or perceptions, or through unpleasant dreams, or to feel or act as if the event itself were itself. re-presenting (this includes feelings of reliving the experience, illusions, hallucinations, flashbacks), or even reacting or experiencing psychological distress if one comes into contact with factors that, in some way, reproduce some aspects of that event. All this leads to conduct to avoid stimuli that have to do with the trauma: efforts to avoid thoughts, sensations or conversations associated with the trauma or to avoid places, people, activities that evoke memories of the same; inability to remember some important aspect (dissociative amnesia); reduction marked of interest or participation in significant activities; feelings of detachment and estrangement from others; inability to have feelings of love; reduction of future prospects (expecting not to have a career, marriage or children or a normal life span). In addition, there is an increase in excitability (which produces difficulty falling asleep or maintaining sleep, irritability or outbursts of anger, difficulty concentrating, hypervigilance, exaggerated alarm responses) and significant discomfort or impairment of the subject's functioning.
To be defined as such, post-traumatic stress disorder must manifest itself within days, weeks or months of the trauma, and must have a minimum duration of one month. There are three types: acute PTSD lasts less than 3 months, chronic over 3 months, and delayed onset when its onset occurs at least 6 months after the stressful event.
Acute stress disorder (DAS) is similar to post-traumatic disease, but differs from it according to a temporal criterion: it occurs within 1 month of the stressful event and lasts from at least 2 days to less than a month. suffering from DAS undergo the same symptoms as those with PTSD, only more intense and disabling.

It is not uncommon for the initial symptoms to appear even years after the original traumatic event.

The course of the disease can be acute or chronic; only a little less than 1/3 of patients undergo complete remission. The evolution is less favorable in children and the elderly.

Therapy is based on psychological and pharmacological treatment with antidepressants, anxiolytics and b-blockers.