Early psychological reactions in a group of individuals with pre-existing and enduring mental health difficulties following a major coach accident.
BACKGROUND
The impact of major trauma on individuals with pre-existing and enduring mental health difficulties is poorly understood.


METHODS
Twenty individuals with pre-existing and enduring mental health difficulties were assessed with the Clinician Administered Post Traumatic Stress Disorder Scale, the 28-item version of the GHO, the Hospital Anxiety and Depression Scale, and the impact of Event Scale between four and eight weeks after their involvement in a major coach accident.


RESULTS
Ten (50%) individuals satisfied the full DSM-IV criteria for a diagnosis of PTSD. The questionnaire scores indicated a high level of psychological suffering among the group. On dividing the sample into those individuals with previous diagnosis of anxiety or depressive disorders and those with a previous diagnosis of chronic schizophrenia, the schizophrenia group displayed less marked psychological sequelae on all measures.


CONCLUSIONS
There was a high incidence of early psychological sequelae among the group as a whole. Some diagnoses (e.g. depression and anxiety) may predispose to psychological sequelae while others (e.g. chronic schizophrenia) may not.
St Tydfil's Hospital, Merthyr Tydfil.
H L
HL
Chubb
J I
JI
Bisson
D000063:Accidents, Traffic / Q000523:psychology*; D000328:Adult; D000368:Aged; D001008:Anxiety Disorders / Q000175:diagnosis / Q000523:psychology; D002908:Chronic Disease; D015897:Comorbidity; D003866:Depressive Disorder / Q000175:diagnosis / Q000523:psychology; D004739:England; D005260:Female; D006801:Humans; D007206:Individuality; D008297:Male; D001523:Mental Disorders / Q000175:diagnosis* / Q000523:psychology; D008875:Middle Aged; D009104:Multiple Trauma / Q000523:psychology; D010555:Personality Inventory / Q000706:statistics & numerical data; D011594:Psychometrics; D012307:Risk Factors; D012559:Schizophrenia / Q000175:diagnosis; D012565:Schizophrenic Psychology; D013313:Stress Disorders, Post-Traumatic / Q000175:diagnosis* / Q000523:psychology; D013534:Survival / Q000523:psychology