Abstract

Accidents constitute traumatic events that can be followed by psychiatric symptomatology which may involve adjustment disorders. Objective: to study clinical features and evolution of patients with adjustment disorder that develop posttraumatic stress symptomatology (ADP). This symptomatology is insufficient to fulfil the diagnostic criteria of acute stress disorder or posttraumatic stress disorder. Methodology: retrospective assessment of clinical charts of work accidents (1996-1998) according to ICD-10 diagnostic criteria and an ad hoc instrument to rate the information. Statistical analysis was made with Epi Info 6.04 program. Results: the sample consisted of 141 patients (54.0% men), 77.3% was referred to an outpatient psychiatric clinic during 30 days post accident. The types of accidents were threat or intentional attack (39.3%), transit accident (26.4%) and workplace accident (34.3%). Principal symptoms were of invasive type (95.0%), anxiety (93.6%) and sleep disorders (87.9%). Combined treatment of psychotropics and psychotherapy lasted 85 days. 62.4% of the patients needed home rest (an average of 57.6 days). Diagnostic stability was obtained in 82.3%. Factors that influenced a precocious referral to psychiatry were type of accident (assault/rape), invasive symptoms and sleep disorders. Conclusions: diagnosis of ADP constitutes an operational construct that enables a precocious referral to psychiatry and a lesser time of treatment. © 2006 Sociedad de Neurolog Psiquiatry Neurocirugbr.