Acute Stress Disorder

In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2023 Jan.


Acute stress disorder (ASD) was first outlined in 1994 at the diagnostic and statistical manual of mental disorders, fourth edition (DSM-IV) as a new diagnosis. The reasoning for adding this diagnosis was to provide healthcare services to patients with acute traumas but who were not covered by insurance due to the condition being in its early stage. Second, it was hoped to predict post-traumatic stress disorder (PTSD) development in acute trauma patients to initiate early interventions.

ASD explains acute stress reactions (ASRs) that occur in no less than three days and no more than four weeks. In contrast, ASRs that continue for a more extended period than four weeks can meet the criteria for post-traumatic stress disorder (PTSD). ASD was defined in an attempt to describe ASRs that were missed or treated as adjustment disorders. DSM-5 no longer requires dissociative symptoms to diagnose ASD while still including it as a diagnostic criterion.

With the introduction of the DSM-5 in 2013, multiple changes were made to the diagnostic criteria. ASD was moved from the anxiety disorders bucket to a newly created bucket (i.e., trauma and stressor-related disorders) to distinguish further its characteristics. Unlike DSM-IV, in DSM-V, dissociative symptoms are no longer a requirement for the diagnosis of ASD.

The etiology, epidemiology, pathophysiology, history, physical examination, evaluation, treatment, side effects, prognosis, differential diagnosis, patient education, and enhancing outcomes of the acute stress disorder will be discussed here.

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