title: Onset and maintenance of psychiatric disorders after serious accidents.
abstract: The purpose of this study was to prospectively investigate the onset, course, and remission of psychiatric disorders in the first 6 months after a serious accident for consecutive patients in a hospital emergency department. Participants were 58 patients aged 18-65 who were assessed shortly after attending a hospital emergency department and were followed up 6 months afterwards. Patients were interviewed with regard to past and current psychiatric history using different instruments (e.g. SCID for DSM-IV). Prior to their accidents, 35% of all subjects had experienced one or more psychiatric disorders (lifetime prevalence). Shortly after the accident, the incidence of Acute Stress Disorder (7%), subsyndromal Acute Stress Disorder (12%), and adjustment disorder (1.5%) was increased as a reaction to the accident. At this time, 29% of all patients suffered from an acute psychiatric disorder. Six-months after the accident, 10% of the subjects met criteria for Major Depression, 6% for PTSD, 4% for subsyndromal PTSD, and 1.5% for Specific Phobia as newly developed disorders. The course of the psychiatric disorders shows that those patients who met criteria for any psychiatric diagnosis shortly after the accident ran a much higher risk for developing new or comorbid psychiatric disorders in the future.
authors.affiliation: Department of Psychiatry and Psychotherapy, University of Schleswig-Holstein, Campus Luebeck, Ratzeburger Allee 160, 23538, Luebeck, Germany.
authors.forename: Manuela
authors.initials: M
authors.lastname: Kühn
authors.forename: Ulrike
authors.initials: U
authors.lastname: Ehlert
authors.forename: Hans-Jürgen
authors.initials: HJ
authors.lastname: Rumpf
authors.forename: Jutta
authors.initials: J
authors.lastname: Backhaus
authors.forename: Fritz
authors.initials: F
authors.lastname: Hohagen
authors.forename: Andreas
authors.initials: A
authors.lastname: Broocks
mesh_terms: D015998:Abbreviated Injury Scale; D000061:Accidents, Home / Q000523:psychology*; D000062:Accidents, Occupational / Q000523:psychology*; D000063:Accidents, Traffic / Q000523:psychology*; D000275:Adjustment Disorders / Q000175:diagnosis / Q000453:epidemiology / Q000523:psychology; D000293:Adolescent; D000328:Adult; D000368:Aged; D001008:Anxiety Disorders / Q000175:diagnosis* / Q000453:epidemiology / Q000523:psychology; D001293:Attitude to Death; D015897:Comorbidity; D003430:Cross-Sectional Studies; D003866:Depressive Disorder / Q000175:diagnosis* / Q000453:epidemiology / Q000523:psychology; D003865:Major Depressive Disorder / Q000175:diagnosis / Q000453:epidemiology / Q000523:psychology; D005239:Fear; D005260:Female; D005500:Follow-Up Studies; D005858:Germany; D006801:Humans; D008297:Male; D008875:Middle Aged; D010698:Phobic Disorders / Q000175:diagnosis / Q000453:epidemiology / Q000523:psychology; D012307:Risk Factors; D013313:Stress Disorders, Post-Traumatic / Q000175:diagnosis* / Q000453:epidemiology / Q000523:psychology; D014947:Wounds and Injuries / Q000523:psychology* / Q000601:surgery