Trial of interpersonal counselling after major physical trauma.
OBJECTIVE
The purpose of the present study was to determine if interpersonal counselling (IPC) was effective in reducing psychological morbidity after major physical trauma.


METHODS
One hundred and seventeen subjects were recruited from two major trauma centres and randomized to treatment as usual or IPC in the first 3 months following trauma. Measures of depressive, anxiety and post-traumatic symptoms were taken at baseline, 3 months and 6 months. The Structured Clinical Interview for DSM IV diagnoses was conducted at baseline and at 6 months to assess for psychiatric disorder.


RESULTS
Fifty-eight patients completed the study. Only half the patients randomized to IPC completed the therapy. At 6 months the level of depressive, anxiety and post-traumatic symptoms and the prevalence of psychiatric disorder did not differ significantly between the intervention and treatment-as-usual groups. Subjects with a past history of major depression who received IPC had significantly higher levels of depressive symptoms at 6 months.


CONCLUSIONS
IPC was not effective as a universal intervention to reduce psychiatric morbidity after major physical trauma and may increase morbidity in vulnerable individuals. Patient dropout is likely to be a major problem in universal multi-session preventative interventions.
Holmes
Alex
A
Department of Psychiatry, University of Melbourne, Melbourne, Victoria, Australia. acnh@unimelb.edu.au
Hodgins
Gene
G
Adey
Sarah
S
Menzel
Shelly
S
Danne
Peter
P
Kossmann
Thomas
T
Judd
Fiona
F
D000328:Adult; D001315:Australia / Q000453:epidemiology; D002908:Chronic Disease; D015897:Comorbidity; D003376:Counseling / Q000379:methods*; D003865:Major Depressive Disorder / Q000453:epidemiology / Q000517:prevention & control* / Q000523:psychology; D004185:Disability Evaluation; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007398:Interpersonal Relations; D008297:Male; D015995:Prevalence; D011613:Psychotherapy / Q000379:methods*; D013313:Stress Disorders, Post-Traumatic / Q000453:epidemiology / Q000517:prevention & control* / Q000628:therapy; D040921:Stress Disorders, Traumatic / Q000453:epidemiology / Q000517:prevention & control / Q000628:therapy*; D013315:Stress, Psychological / Q000175:diagnosis / Q000453:epidemiology / Q000517:prevention & control; D014193:Trauma Centers / Q000706:statistics & numerical data; D015599:Trauma Severity Indices; D016896:Treatment Outcome; D014947:Wounds and Injuries / Q000175:diagnosis / Q000453:epidemiology* / Q000523:psychology*