Trauma- and Stressor-Related Disorders

Aging adults experience many stressful events, and psychiatric symptoms associated with these events can exert a significant impact (Murayama et al., Geriatr Gerontol Int 20:297–303, 2020). Loss of loved ones, changes in living situation, impaired mobility, surgery, loss of employment, financial demands, acute medical conditions, and various physical disabilities are common. Psychological and social reserves in the geriatric patient may afford resilience and facilitate successful adaptation (Whitson et al., J Gerontol A Biol Sci Med Sci 71:489–495, 2016). A thorough history from both the patient and reliable observers who know the patient’s baseline can also aid in the early identification of stressors and maladaptive responses. The syndrome of post-traumatic stress disorder (PTSDPost-traumatic stress disorder (PTSD)) although often categorized under anxiety disorders is included here because it is the result of significant stressors which may have occurred earlier in life and may be overlooked in the aging adult (see Fig. 13.1). Symptoms of adjustment disorder, acute stress disorder, posttraumatic stress disorder (PTSDPost-traumatic stress disorder (PTSD)), persistent complex bereavement, and/or bereavement may be overlooked by the busy clinician who must focus on the current medical symptomatology. This chapter provides an overview of stress-related syndromes in the geriatric patient to encourage early recognition and prompt age-adjusted interventions (see Table 13.1).