Time course of symptoms in posttraumatic stress disorder with delayed expression: A systematic review
Publikation: Bidrag til tidsskrift › Review › Forskning › fagfællebedømt
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Time course of symptoms in posttraumatic stress disorder with delayed expression : A systematic review. / Bonde, Jens Peter Ellekilde; Jensen, Johan Hoy; Smid, Geert E.; Flachs, Esben Meulengracht; Elklit, Ask; Mors, Ole; Videbech, Poul.
I: Acta Psychiatrica Scandinavica, Bind 145, Nr. 2, 2022, s. 116-131.Publikation: Bidrag til tidsskrift › Review › Forskning › fagfællebedømt
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TY - JOUR
T1 - Time course of symptoms in posttraumatic stress disorder with delayed expression
T2 - A systematic review
AU - Bonde, Jens Peter Ellekilde
AU - Jensen, Johan Hoy
AU - Smid, Geert E.
AU - Flachs, Esben Meulengracht
AU - Elklit, Ask
AU - Mors, Ole
AU - Videbech, Poul
PY - 2022
Y1 - 2022
N2 - Objective To examine the hypothesis that PTSD with delayed expression in some cases occurs without subthreshold PTSD symptoms above background levels bridging the gap between the traumatic exposure(s) and the clinical diagnosis. Methods We performed systematic searches of peer-reviewed papers in English referenced in Pubmed, Embase, or PsycINFO and ascertained 34 prospective studies of PTSD symptom trajectories identified by latent class growth statistical modeling. Studies with delayed and low-stable trajectories provided appropriate data for this study. We computed the difference between the delayed trajectory PTSD symptom sumscore and the low-stable PTSD sumscore at the observed points in time after the traumatic event(s). Results In 29 study populations, the latent class growth analyses displayed delayed trajectories, and in these, we identified 110 data points (% PTSD sumscore difference/months since traumatic exposure). The median PTSD symptom sumscore was 25% higher during the initial 6 months among individuals in the delayed trajectory compared to those in low-stable trajectory. From this level, the difference widened and reached a plateau of 40-50% higher. The variation was large, and the baseline participation rate and loss to follow-up were exceeding 25% in the majority of the studies. Heterogeneity of populations, measures, and analyses precluded formal meta-analysis. Conclusion Delayed PTSD is preceded by PTSD symptoms during the first year in most cases. Still, few individuals may experience an asymptomatic delay. The results underpin the rationale for monitoring PTSD symptoms and may inform forensic assessments in that delayed PTSD without symptoms bridging the traumatic event is rare.
AB - Objective To examine the hypothesis that PTSD with delayed expression in some cases occurs without subthreshold PTSD symptoms above background levels bridging the gap between the traumatic exposure(s) and the clinical diagnosis. Methods We performed systematic searches of peer-reviewed papers in English referenced in Pubmed, Embase, or PsycINFO and ascertained 34 prospective studies of PTSD symptom trajectories identified by latent class growth statistical modeling. Studies with delayed and low-stable trajectories provided appropriate data for this study. We computed the difference between the delayed trajectory PTSD symptom sumscore and the low-stable PTSD sumscore at the observed points in time after the traumatic event(s). Results In 29 study populations, the latent class growth analyses displayed delayed trajectories, and in these, we identified 110 data points (% PTSD sumscore difference/months since traumatic exposure). The median PTSD symptom sumscore was 25% higher during the initial 6 months among individuals in the delayed trajectory compared to those in low-stable trajectory. From this level, the difference widened and reached a plateau of 40-50% higher. The variation was large, and the baseline participation rate and loss to follow-up were exceeding 25% in the majority of the studies. Heterogeneity of populations, measures, and analyses precluded formal meta-analysis. Conclusion Delayed PTSD is preceded by PTSD symptoms during the first year in most cases. Still, few individuals may experience an asymptomatic delay. The results underpin the rationale for monitoring PTSD symptoms and may inform forensic assessments in that delayed PTSD without symptoms bridging the traumatic event is rare.
KW - forensic psychiatry
KW - latent class growth analysis
KW - partial PTSD
KW - subthreshold PTSD
KW - trajectory analysis
KW - veterans
KW - PROSPECTIVE TRAJECTORIES
KW - MILITARY PERSONNEL
KW - MENTAL-HEALTH
KW - ONSET PTSD
KW - ISRAELI VETERANS
KW - RESILIENCE
KW - INJURY
KW - RISK
KW - RECOGNITION
KW - PREVALENCE
U2 - 10.1111/acps.13372
DO - 10.1111/acps.13372
M3 - Review
C2 - 34523121
VL - 145
SP - 116
EP - 131
JO - Acta Psychiatrica Scandinavica. Supplementum
JF - Acta Psychiatrica Scandinavica. Supplementum
SN - 0065-1591
IS - 2
ER -
ID: 281643742