Because this patients symptoms have persisted for more than 1 month, he meets criteria for PTSD. Acute stress disorder is differentiated from PTSD based on duration of symptoms. In acute stress disorder, symptoms must occur within 4 weeks of the traumatic event and resolve within the 4-week period.1 Patients with social anxiety disorder, or social phobia, tend to avoid situations (eg, being in a new environment, meeting new people) that would provoke anxiety. As a result, they often decline invitations to social events. However, patients with social anxiety disorder do not show changes in sleep patterns and appetite and do not have amnesia associated with a traumatic event, as seen in the case patient.1 Patients with generalized anxiety
disorder have difficulty controlling apprehension and anxiety, but the focus of the anxiety and worry is not related to other Axis I disorders (eg, panic attacks in panic disorder, being easily embarrassed in public as in social phobia, being contaminated as in obsessive-compulsive disorder).1
1. American Psychiatric Association. Diagnostic and statistical manual of mental disorders: DSM-IV-TR. 4th ed., text revision. Washington (DC): The Association; 2000:463–86.
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Seminars in Medical Practice
Hospital Physician Board Review Manuals
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Updated 12/18/08 nvf