Trauma- and stressor-related disorders
Differential diagnostics
- Generalized anxiety disorder: If symptoms of adjustment disorder last > 6 months the diagnosis is changed to GAD.
| Acute Distress Disorder | Adjustment Disorder | PTSD | |
|---|---|---|---|
| Type of Stressor | Severe | Mild/Moderate | Severe |
| Time between stress and symptoms | Few days to maximum 4 weeks | Up to 3 months | Not fixed; sometimes years |
| Duration of symptoms | Maximum one month | ≤ 6 months after end of stressor | > 1 month |
- Adjustment disorder
- Etiology: a combination of intrinsic and extrinsic stressors (e.g., divorce, losing a job, academic failure, difficulties with a peer group, illness)
- It's called "adjustment", because the stressor is mild and people just need to adjust.
- Etiology: a combination of intrinsic and extrinsic stressors (e.g., divorce, losing a job, academic failure, difficulties with a peer group, illness)
Treatment
- First-line: psychotherapy with or without adjunctive pharmacotherapy
- Trauma-focused cognitive-behavioral therapy
- Eye movement desensitization and reprocessing
- Pharmacotherapy
- SSRIs, SNRIs (e.g., venlafaxine)
- Prazosin: for nightmares
- Benzodiazepines should generally be avoided due to the risk of misuse and lack of evidence supporting the benefits.