Posttraumatic distress, alcohol disorders, and recurrent trauma across level 1 trauma centers.
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.
Zatzick
Douglas
D
Department of Psychiatry and Behavioral Science, University of Washington School of Medicine, Seattle, Washington 98104-2499, USA. dzatzick@u.washington.edu
Jurkovich
Gregory
G
Russo
Joan
J
Roy-Byrne
Peter
P
Katon
Wayne
W
Wagner
Amy
A
Dunn
Chris
C
Uehara
Edwina
E
Wisner
David
D
Rivara
Frederick
F
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