Delayed posttraumatic stress disorder: System review, meta-analysis, and meta-regression analysis of prospective studies

Occurrence of delayed-onset post-traumatic stress disorder: a systematic review and meta-analysis of prospective studies

“…Our results corroborate findings in an earlier review based upon group-as well as case-reports (16) and a systematic review applying the same methodology as ours (17). Military personnel, firefighters, rescue workers, and police tended to have a lower absolute prevalence of PTSD, but a significantly higher proportion of delayedonset PTSD in comparison with civilian groups.…”

“…The authors concluded that the former commonly accounts for some 40% of military and 15% of civilian cases, while true delayedonset PTSD is rare. This conclusion is corroborated by a meta-analysis of 24 prospective studies with repeated examinations performed 1-6 months and >1 year after the traumatic event (17). Smid et al's review included papers published before April 2008 and observed delayed-onset PTSD in 25% (95% CI 23-27) of all PTSD cases, but few developed the disorder without early sub-threshold PTSD symptoms.…”

“…Because of the inclusion of some recent large studies in our review, the combined number of participants in this meta-analysis is more than five times higher than in Smid et al's latest review (17). The objective of the present review was to estimate the proportion of delayed-onset PTSD and examine if it is associated with the type of traumatic event, type of population, and presence of sub-threshold PTSD symptoms during the initial months after the trauma.…”

“…Addition of some recent large studies to this review brings the combined number of participants in the meta-analysis to more than five times higher than in the latest review (Smid et al, 2009).Affiliation: …”

“…So far the issue of delayedonset PTSD has been addressed in two systematic reviews (16,17). In 2007, Andrews et al (16)reviewed 10 casestudies and 19 studies with retro-or prospective data on the development of delayed-onset PTSD and emphasized the need to distinguish between (i) cases where PTSD symptoms start during the first months following a traumatic event, but the full PTSD syndrome fulfilling all DSM criteria only becomes manifest >6 months (exacerbated PTSD) and (ii) cases where the very first symptoms of PTSD start after a silent asymptomatic period of ≥6 months with delayed development of the full PTSD syndrome (true delayed-onset PTSD).…”