TY - JOUR T1 - Occurrence of delayed-onset post-traumatic stress disorder: a systematic review and meta-analysis of prospective studies JO - Scandinavian Journal of Work, Environment & Health PY - 2014/5VL - 40 IS - 3 SP - 215 EP - 229 AU - Utzon-Frank, Nicolai AU - Breinegaard, Nina AU - Bertelsen, Mette AU - Borritz, Marianne AU - Eller, Nanna Hurwitz AU - Nordentoft, Mads AU - Olesen, Kasper AU - Rod, Naja H AU - Rugulies, Reiner AU - Bonde, Jens Peter M3 - doi: 10.5271/sjweh.3420 UR - https://www.sjweh.fi/show_abstract.php?abstract_id=3420 KW - accident KW - catastrophe KW - deployment KW - disaster KW - mental disease KW - meta-analysis KW - post-traumatic stress disorder KW - PTSD KW - review KW - systematic review KW - trajectory N2 - '

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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).

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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

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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.

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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.

SN - 0355-3140 ER -