Differential diagnostics


Acute Distress DisorderAdjustment DisorderPTSD
Type of StressorSevereMild/ModerateSevere
Time between stress and symptomsFew days to maximum 4 weeksUp to 3 monthsNot fixed; sometimes years
Duration of symptomsMaximum 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.

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.