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Protracted acute stress reaction following an earthquake


Prof. Constantin R. Soldatos MD, Head, Disaster Research Unit, Department of Psychiatry, Athens University Medical School, 74 Vas. Sophias Ave, 11 528 Athens, Greece E-mail:


Objective: To verify the official criteria of ICD-10 diagnosis of acute stress reaction (ASR) among earthquake victims.

Method: Data on psychosocial variables and the diagnosis of ASR were collected from 91 subjects.

Results: The diagnosis of ASR was made in 70% of the sample. However, the restrictive duration criterion (i.e. symptoms not exceeding the first 48 h) was fulfilled only in 10%; in the remaining 60% the symptoms lasted for about another week. Thus, 60% of the sample constituted a group with protracted ASR (PASR) and 40% a group without it (n-PASR). Medical history was more frequent among PASR than n-PASR; PASR showed higher anxiety levels (both pre- and post-disaster) than n-PASR; finally, the persistence of ASR related positively to the fear of death at the time of the earthquake and pre-disaster anxiety levels.

Conclusion: As in the vast majority of earthquake victims the ASR is protracted beyond 48 h, a revision of ICD-10 guidelines should be considered.