Acute stress disorder physical examination

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]Associate Editor(s)-in-Chief: Simrat Sarai, M.D. [2]

Physical Examination

If serious signs appear and last more than a couple of weeks, help should be sought. Signs that need help include the following:

Signs	Signs for which help is needed include the following
Sign 1	Extended depression and loss of interest in activities and events
Sign 2	Inability to sleep, loss of appetite, or prolonged fear of being alone
Sign 3	Extended period of marked regression
Sign 4	Excessive imitation of the deceased or repeated statements about wanting to join the deceased
Sign 5	Withdrawal from friends
Sign 6	Encourage bereaved individuals to care for themselves
Sign 7	Serious drop in school performance or refusal to go to school
Sign 8	Persistent fears
Sign 9	Persistent irritability and being easily startled
Sign 10	Behavior problems
Sign 11	physical complaints

Appearance of the patient

• Patients may be disheveled and unclean and may show the effects of dehydration and failure to care for themselves

Mental status examination

• The mental status examination is used to assess the patient's current mental condition
• Affect and mood
  • Patients may appear anxious, sad, irritable, apathetic, emotionally labile, angry, or calm
• Thought content
  • Individuals may feel helpless, be confused, be in a state of disbelief, have markedly impaired concentration, have lowered self-esteem, or be driven to search for the deceased
• Perceptions
  • Patients may have visual or auditory hallucinations that the deceased person is present; feelings of unreality, flashbacks, numbness, and denial may occur
• Judgment and insight
  • Confusion in combination with preoccupation with those they have lost may be present that impair an individuals’ judgment and insight
• Suicidal or homicidal ideation
  • Suicidal thoughts occur in as many as approximately 54% of survivors and may continue up to 6 months after the death; thoughts or plans of homicide may be present

Heart

• Palpitations
• Chest pain

Abdomen

• Gastrointestinal distress

Neuromuscular

Headache