Posttraumatic stress reactions after injury.
BACKGROUND
Many individuals experience psychological distress after injury. It is unclear whether poor psychological outcome reflects pretrauma variables.


METHODS
In a prospective, cross-sectional study, 152 accident and emergency department patients with physical injuries and an acute stress reaction completed trauma and psychometric questionnaires, including the Impact of Event Scale and the Hospital Anxiety and Depression Scale.


RESULTS
Although levels of pretrauma social, occupational, and familial functioning were high, and the modal Abbreviated Injury Scale score was 1, there were high levels of psychological distress at 3 weeks. Mean Hospital Anxiety and Depression Scale anxiety and depression scores were 11.8 (SD, 4.4) and 8.7 (SD, 4.4), respectively. The mean total Impact of Event Scale score was 46.0 (SD, 16.1). Stepwise linear regression analysis found unemployment and previous history of trauma to be associated with increased symptoms of traumatic stress.


CONCLUSIONS
Trauma patients with high levels of pretrauma functioning may develop acute psychological distress. Unemployment and previous trauma increase risk. Psychological wellbeing should be considered in routine injury assessments.
Joy
D
D
Department of Oral Surgery, Medicine, and Pathology, Dental School, University of Wales College of Medicine, Heath Park, Cardiff, United Kingdom.
Probert
R
R
Bisson
J I
JI
Shepherd
J P
JP
D000293:Adolescent; D000328:Adult; D000368:Aged; D003430:Cross-Sectional Studies; D005260:Female; D006801:Humans; D008016:Life Change Events; D008297:Male; D008875:Middle Aged; D009104:Multiple Trauma / Q000523:psychology*; D010555:Personality Inventory / Q000706:statistics & numerical data; D011446:Prospective Studies; D011594:Psychometrics; D012307:Risk Factors; D013313:Stress Disorders, Post-Traumatic / Q000175:diagnosis* / Q000523:psychology