Early psychosocial intervention following traumatic events.

Bill, a 35-year-old journalist working for a local radio station, was sent to report from the scene of a bomb attack that resulted in several fatalities. What he witnessed at the scene distressed him greatly. Immediately afterward, he began repeatedly to reexperience what had happened, leading him to avoid either discussing or thinking about it. He continued to work, but he lost interest in things around him. He became withdrawn, irritable, and hypervigilant. These symptoms rapidly diminished over the first few weeks, but then 1 month after the attack they began to increase again for no apparent reason. What is the differential diagnosis? How should Bill’s symptoms be managed?