title: Posttraumatic distress, alcohol disorders, and recurrent trauma across level 1 trauma centers.
abstract: BACKGROUND
  Injured survivors of individual and mass trauma receive their initial evaluation in acute care. Few investigations have comprehensively screened for posttraumatic stress disorder (PTSD) symptoms and related comorbidities across sites.
  
  
  METHODS
  This investigation included 269 randomly selected injury survivors hospitalized at two level 1 trauma centers. All patients were screened for PTSD, depressive, and peritraumatic dissociative symptoms during their surgical inpatient admission. Prior traumatic life events and alcohol abuse/dependence also were assessed.
  
  
  RESULTS
  In this study, 58% of the patients demonstrated high levels of immediate posttraumatic distress or alcohol abuse/dependence. Regression analyses identified greater prior trauma, female gender, nonwhite ethnicity, and site as significant independent predictors for high levels of posttraumatic distress.
  
  
  CONCLUSIONS
  High levels of posttraumatic distress, recurrent trauma, and alcohol abuse/dependence were present in more than half of acute care inpatients. Early mental health screening and intervention procedures that target both PTSD and alcohol use should be developed for acute care settings.
authors.affiliation: Department of Psychiatry and Behavioral Science, University of Washington School of Medicine, Seattle, Washington 98104-2499, USA. dzatzick@u.washington.edu
authors.forename: Douglas
authors.initials: D
authors.lastname: Zatzick
authors.forename: Gregory
authors.initials: G
authors.lastname: Jurkovich
authors.forename: Joan
authors.initials: J
authors.lastname: Russo
authors.forename: Peter
authors.initials: P
authors.lastname: Roy-Byrne
authors.forename: Wayne
authors.initials: W
authors.lastname: Katon
authors.forename: Amy
authors.initials: A
authors.lastname: Wagner
authors.forename: Chris
authors.initials: C
authors.lastname: Dunn
authors.forename: Edwina
authors.initials: E
authors.lastname: Uehara
authors.forename: David
authors.initials: D
authors.lastname: Wisner
authors.forename: Frederick
authors.initials: F
authors.lastname: Rivara
mesh_terms: D000328:Adult; D000437:Alcoholism / Q000175:diagnosis / Q000453:epidemiology* / Q000209:etiology; D002140:California / Q000453:epidemiology; D016022:Case-Control Studies; D015897:Comorbidity; D003866:Depressive Disorder / Q000175:diagnosis / Q000453:epidemiology* / Q000209:etiology; D004213:Dissociative Disorders / Q000150:complications / Q000175:diagnosis / Q000453:epidemiology*; D005260:Female; D006760:Hospitalization / Q000706:statistics & numerical data; D006801:Humans; D015601:Injury Severity Score; D008016:Life Change Events; D016015:Logistic Models; D008297:Male; D008403:Mass Screening; D009104:Multiple Trauma / Q000150:complications / Q000453:epidemiology*; D011237:Predictive Value of Tests; D012008:Recurrence; D012307:Risk Factors; D013313:Stress Disorders, Post-Traumatic / Q000150:complications / Q000175:diagnosis / Q000453:epidemiology*; D011795:Surveys and Questionnaires; D017741:Survivors / Q000706:statistics & numerical data; D014193:Trauma Centers; D014861:Washington / Q000453:epidemiology