Occurrence of delayed-onset post-traumatic stress disorder: a systematic review and meta-analysis of prospective studies
OBJECTIVE: Post-traumatic stress disorder (PTSD) develops according to consensus criteria within the first 1–6 months after a horrifying traumatic event, but it is alleged that PTSD may develop later. The objective was to review the evidence addressing occurrence of PTSD with onset >6 months afte...
| Main Authors: | , , , , , , , , , |
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| Format: | Article |
| Language: | English |
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Nordic Association of Occupational Safety and Health (NOROSH)
2014-05-01
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| Series: | Scandinavian Journal of Work, Environment & Health |
| Subjects: | |
| Online Access: |
https://www.sjweh.fi/show_abstract.php?abstract_id=3420
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| _version_ | 1818941657551208448 |
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| author | Nicolai Utzon-Frank Nina Breinegaard Mette Bertelsen Marianne Borritz Nanna Hurwitz Eller Merete Nordentoft Kasper Olesen Naja Hulvej Rod Reiner Rugulies Jens Peter Bonde |
| author_facet | Nicolai Utzon-Frank Nina Breinegaard Mette Bertelsen Marianne Borritz Nanna Hurwitz Eller Merete Nordentoft Kasper Olesen Naja Hulvej Rod Reiner Rugulies Jens Peter Bonde |
| author_sort | Nicolai Utzon-Frank |
| collection | DOAJ |
| description | OBJECTIVE: Post-traumatic stress disorder (PTSD) develops according to consensus criteria within the first 1–6 months after a horrifying traumatic event, but it is alleged that PTSD may develop later. The objective was to review the evidence addressing occurrence of PTSD with onset >6 months after a traumatic event (delayed-onset PTSD). METHODS: Through a systematic search in PubMed, EMBASE, and PsycINFO, we identified 39 studies with prospective ascertainment of PTSD. A meta-analysis was performed in order to obtain a weighted estimate of the average proportion of delayed-onset PTSD cases, and meta-regression was used to examine effects of several characteristics RESULTS: Delayed-onset PTSD was reported in all studies except one, and the average prevalence across all follow-up time was 5.6% [95% confidence interval (95% CI) 4.3–7.3%]. The proportion with delayed-onset PTSD relative to all cases of PTSD was on average 24.5% (95% CI 19.5–30.3%) with large variation across studies. In six studies with sub-threshold symptom data, delayed-onset PTSD seemed most likely an aggravation of early symptoms. The proportion with delayed-onset PTSD was almost twice as high among veterans and other professional groups compared to non-professional victims. CONCLUSION: Descriptive follow-up data suggest that PTSD may manifest itself >6 months after a traumatic event, delayed-onset PTSD most often, if not always, is preceded by sub-threshold PTSD symptoms, and a higher proportion of PTSD cases are delayed among professional groups. Contextual factors and biased recall may inflate reporting of PTSD and a cautious interpretation of prevalence rates seems prudent. |
| first_indexed | 2024-12-20T06:59:01Z |
| format | Article |
| id | doaj.art-730dad04065d4c1485690fd71e723455 |
| institution | Directory Open Access Journal |
| issn | 0355-3140 1795-990X |
| language | English |
| last_indexed | 2024-12-20T06:59:01Z |
| publishDate | 2014-05-01 |
| publisher | Nordic Association of Occupational Safety and Health (NOROSH) |
| record_format | Article |
| series | Scandinavian Journal of Work, Environment & Health |
| spelling | doaj.art-730dad04065d4c1485690fd71e7234552022-12-21T19:49:14ZengNordic Association of Occupational Safety and Health (NOROSH)Scandinavian Journal of Work, Environment & Health0355-31401795-990X2014-05-0140321522910.5271/sjweh.34203420Occurrence of delayed-onset post-traumatic stress disorder: a systematic review and meta-analysis of prospective studiesNicolai Utzon-Frank0Nina BreinegaardMette BertelsenMarianne BorritzNanna Hurwitz EllerMerete NordentoftKasper OlesenNaja Hulvej RodReiner RuguliesJens Peter BondeDepartment of Occupational and Environmental Medicine, Bispebjerg Bakke 23, Bispebjerg Hospital, Denmark.OBJECTIVE: Post-traumatic stress disorder (PTSD) develops according to consensus criteria within the first 1–6 months after a horrifying traumatic event, but it is alleged that PTSD may develop later. The objective was to review the evidence addressing occurrence of PTSD with onset >6 months after a traumatic event (delayed-onset PTSD). METHODS: Through a systematic search in PubMed, EMBASE, and PsycINFO, we identified 39 studies with prospective ascertainment of PTSD. A meta-analysis was performed in order to obtain a weighted estimate of the average proportion of delayed-onset PTSD cases, and meta-regression was used to examine effects of several characteristics RESULTS: Delayed-onset PTSD was reported in all studies except one, and the average prevalence across all follow-up time was 5.6% [95% confidence interval (95% CI) 4.3–7.3%]. The proportion with delayed-onset PTSD relative to all cases of PTSD was on average 24.5% (95% CI 19.5–30.3%) with large variation across studies. In six studies with sub-threshold symptom data, delayed-onset PTSD seemed most likely an aggravation of early symptoms. The proportion with delayed-onset PTSD was almost twice as high among veterans and other professional groups compared to non-professional victims. CONCLUSION: Descriptive follow-up data suggest that PTSD may manifest itself >6 months after a traumatic event, delayed-onset PTSD most often, if not always, is preceded by sub-threshold PTSD symptoms, and a higher proportion of PTSD cases are delayed among professional groups. Contextual factors and biased recall may inflate reporting of PTSD and a cautious interpretation of prevalence rates seems prudent. https://www.sjweh.fi/show_abstract.php?abstract_id=3420 mental diseasedisastercatastrophereviewmeta-analysisaccidentsystematic reviewdeploymenttrajectorypost-traumatic stress disorderptsd |
| spellingShingle | Nicolai Utzon-Frank Nina Breinegaard Mette Bertelsen Marianne Borritz Nanna Hurwitz Eller Merete Nordentoft Kasper Olesen Naja Hulvej Rod Reiner Rugulies Jens Peter Bonde Occurrence of delayed-onset post-traumatic stress disorder: a systematic review and meta-analysis of prospective studies Scandinavian Journal of Work, Environment & Health mental disease disaster catastrophe review meta-analysis accident systematic review deployment trajectory post-traumatic stress disorder ptsd |
| title | Occurrence of delayed-onset post-traumatic stress disorder: a systematic review and meta-analysis of prospective studies |
| title_full | Occurrence of delayed-onset post-traumatic stress disorder: a systematic review and meta-analysis of prospective studies |
| title_fullStr | Occurrence of delayed-onset post-traumatic stress disorder: a systematic review and meta-analysis of prospective studies |
| title_full_unstemmed | Occurrence of delayed-onset post-traumatic stress disorder: a systematic review and meta-analysis of prospective studies |
| title_short | Occurrence of delayed-onset post-traumatic stress disorder: a systematic review and meta-analysis of prospective studies |
| title_sort | occurrence of delayed onset post traumatic stress disorder a systematic review and meta analysis of prospective studies |
| topic | mental disease disaster catastrophe review meta-analysis accident systematic review deployment trajectory post-traumatic stress disorder ptsd |
| url |
https://www.sjweh.fi/show_abstract.php?abstract_id=3420
|
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