A 25-year-old man is brought to the emergency department by his family 5 days after surviving a building collapse. He is experiencing intrusive flashbacks, severe insomnia, hypervigilance, and a sense of numbness. Based on the symptom duration and timeline, what is the most appropriate diagnosis?

• A Post-Traumatic Stress Disorder (PTSD)
• B Brief Psychotic Disorder
• C Adjustment Disorder
• D Acute Stress Disorder (ASD) ✓

Explanation

ASD is diagnosed when symptoms last from 3 days to 1 month after the trauma. PTSD requires symptoms to persist for more than 1 month. Since this patient is 5 days post-trauma, the correct diagnosis is ASD. Adjustment disorder lacks the characteristic intrusion and hyperarousal clusters, and brief psychotic disorder requires psychotic symptoms like delusions or hallucinations, which are not described here.

Reference: Kaplan and Sadock's Synopsis of Psychiatry, 12th ed.

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