Patients feel overwhelmed or unable to cope.
There may be stress-related physical symptoms such as insomnia,
headache, abdominal pain, chest pain, palpitations.
Acute reaction to recent stressful or traumatic event.
Extreme distress resulting from a recent event, or
preoccupation with the event.
Symptoms may be primarily somatic.
Other symptoms may include: low or sad mood, anxiety,
worry, feeling unable to cope. Acute reaction usually lasts
from a few days to several weeks.
If dissociative symptoms (sudden onset of unusual or dramatic
somatic symptoms) are present, see Dissociative (conversion)
disorder - F45.
Acute symptoms may persist or evolve over time. If significant
symptoms persist longer than one month, consider an alternative
if significant symptoms of depression persist, see
Depression - F32
if significant symptoms of anxiety persist, see
Genralized anxiety - F41.1
if stress-related somatic symptoms persist, see
Unexplained somatic complaints -F45.
if symptoms are due to loss of a loved one, see
Bereavement disorders - Z63.
Adjustment disorder - management guidelines
Essential information for patient and family
Stressful events often have mental and physical effects.
Stress-related symptoms usually last only a few days or
Counselling of patient and family
Encourage the patient to acknowledge the personal
significance of the stressful event.
Review and reinforce positive steps the patient has taken to
deal with the stress.
Identify steps the patient can take to modify the
situation that produced the
stress. If the situation cannot be changed, discuss
Identify relatives, friends and community resources able
to offer support.
Short-term rest and relief from stress may help the
Encourage a return to usual activities within a few
Most acute stress reactions will resolve without use of
medication. However, if severe anxiety symptoms occur, use
antianxiety drugs for up to three days (e.g., benzodiazepines
such as lorazepam 0.5-1.0mg up to three times a day).
If the patient has severe insomnia, use hypnotic drugs for up to
three days (e.g., temaxepam 15mg each night).
If symptoms last longer than one month, consider a more specific
diagnosis (see Differential diagnosis). Follow advice regarding
consultation for that diagnosis.