Psychiatric morbidity associated with motor vehicle accidents.
The primary purpose of this report was to determine the extent of psychiatric morbidity and comorbidity among a sample of recent victims of motor vehicle accidents (MVAs) in comparison to a nonaccident control population. Victims of recent MVAs (N = 158), who sought medical attention as a result of the MVA, were assessed in a University-based research clinic, 1 to 4 months after the accident for acute psychiatric and psychosocial consequences as well as for pre-MVA psychopathology using structured clinical interviews (Clinician-Administered PTSD Scale, SCID, SCID-II, LIFE Base). Age- and gender-matched controls (N = 93) who had had no MVAs in the past year served as controls. Sixty-two MVA victims (39.2%) met DSM-III-R criteria for posttraumatic stress disorder (PTSD), and 55 met DSM-IV criteria. The MVA victims who met the criteria for PTSD were more subjectively distressed and had more impairment in role function (performance at work/school/homemaking, relationships with family or friends) than the MVA victims who did not meet the PTSD criteria or the controls. A high percentage (53%) of the MVA-PTSD group also met the criteria for current major depression, with most of that developing after the MVA. A prior history of major depression appears to be a risk factor for developing PTSD after an MVA (p = .0004): 50% of MVA victims who developed PTSD had a history of previous major depression, as compared with 23% of those with a less severe reaction to the MVA. A prior history of PTSD from earlier trauma also is associated with developing PTSD or a subsyndromal form of it (25.2%) (p = .0012). Personal injury MVAs exact substantial psychosocial costs on the victims. Early intervention, especially in vulnerable populations, might prevent some of this.
Blanchard
E B
EB
Center for Stress and Anxiety Disorders, University at Albany-SUNY 12203, USA.
Hickling
E J
EJ
Taylor
A E
AE
Loos
W
W
D000063:Accidents, Traffic / Q000523:psychology; D000293:Adolescent; D000328:Adult; D000368:Aged; D001334:Automobile Driving / Q000523:psychology; D015897:Comorbidity; D003866:Depressive Disorder / Q000175:diagnosis / Q000453:epidemiology; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D001523:Mental Disorders / Q000175:diagnosis / Q000453:epidemiology*; D008875:Middle Aged; D010555:Personality Inventory; D010698:Phobic Disorders / Q000175:diagnosis / Q000453:epidemiology / Q000523:psychology; D015995:Prevalence; D011569:Psychiatric Status Rating Scales; D012307:Risk Factors; D013313:Stress Disorders, Post-Traumatic / Q000175:diagnosis / Q000453:epidemiology*