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急性应激障碍：流行病学、临床表现和诊断

Author
Richard Bryant, PhD
Section Editor
Murray B Stein, MD, MPH
Deputy Editor
Richard Hermann, MD
Translators
张五芳, 主治医师

引言

急性应激障碍(acute stress disorder, ASD)的特点是个体暴露于创伤性事件后第1个月内可能出现的急性应激反应。该障碍包括分离症状、再体验症状、回避症状和警觉症状。一些经历ASD的患者会继续经历创伤后应激障碍(posttraumatic stress disorder, PTSD)，只有在暴露于创伤的4周后才能诊断为PTSD。

ASD的治疗主要是是针对创伤的认知行为治疗，旨在减少急性应激反应的症状和防止其发展为PTSD。

ASD的流行病学、发病机制、临床表现、病程、诊断和治疗将在此介绍。ASD的治疗将单独讨论。PTSD的流行病学、发病机制、临床表现、病程、诊断和治疗也将单独讨论。PTSD相关的分离以及PTSD相关的物质滥用也将单独讨论。 (参见“成人创伤后应激障碍：流行病学、病理生理、临床表现、病程和诊断”和“成人创伤后应激障碍的药物治疗”和“成人创伤后应激障碍的心理治疗”和“创伤后应激障碍分离性方面的流行病学、临床表现、评估和诊断”和“成人焦虑相关障碍合并物质使用障碍的流行病学、发病机制、临床表现、病程、评估及诊断”，关于‘创伤后应激障碍’一节)

流行病学

患病率 — 创伤暴露后ASD的时点患病率估计在5%-20%之间，取决于创伤的性质和严重程度以及用以识别ASD的工具。具体类型的创伤后ASD发生率包括：

  • 机动车事故：13%[1]，21%[2]
  • 轻度创伤性脑损伤：14%[2]
  • 袭击：16%[3]，19%[4]
  • 烧伤：10%[3]
  • 工伤事故：6%[5]，12%[3]
  • 目睹大规模枪击事件：33%[6]

         

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Literature review current through: 2017-06 . | This topic last updated: 2017-02-17.
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