Psychiatric disorders after an accident: predictors and the influence of the psychiatric condition prior to an accident.
BACKGROUND
The goal of this study is to assess prevalence and incidence of psychiatric sequelae in a sample of inpatient accident survivors. Such an attempt to assess psychiatric conditions that originate due to an accident seems to be important; this does not include psychiatric conditions already present prior to the accident.


METHODS
208 accident victims were consecutively examined over a period of 12months using DSM-IV diagnostic assessment, CAPS, and self-evaluating questionnaires as well as ISS for injury severity. A predictor model for psychiatric disorders was set up.


RESULTS
Incidence of newly developed Axis I disorders in our sample was 14.2% (6months) and 12.3% (12months). Incidence of PTSD was 5.9% (6months) and 2.5% (12months). Comorbidity was a general phenomenon. The psychiatric condition prior to the accident could be identified as a predictor for the development of Axis I disorders. The subjectively evaluated intensity of experienced threat to life and female gender were the main predictors for the development of PTSD.


CONCLUSIONS
Accidents can lead to different psychiatric disorders. PTSD as a single diagnosis is rare. Without taking into account pre-existing disorders, the incidence may be overestimated. Two predictor models for the development of PTSD and other mental disorders are presented.
Wrenger
Marco
M
Department of Psychosomatics and Psychotherapy, University Hospital Münster, Domagkstrasse 22, D-48149 Münster, Germany. marco.wrenger@ukmuenster.de
Lange
Corinna
C
Langer
Martin
M
Heuft
Gereon
G
Burgmer
Markus
M
D000059:Accidents / Q000523:psychology* / Q000706:statistics & numerical data; D000293:Adolescent; D000328:Adult; D000368:Aged; D015897:Comorbidity; D003430:Cross-Sectional Studies; D005260:Female; D005500:Follow-Up Studies; D005858:Germany; D006801:Humans; D015994:Incidence; D015601:Injury Severity Score; D008297:Male; D001523:Mental Disorders / Q000175:diagnosis / Q000453:epidemiology* / Q000523:psychology; D008875:Middle Aged; D012307:Risk Factors; D013313:Stress Disorders, Post-Traumatic / Q000175:diagnosis / Q000453:epidemiology* / Q000523:psychology; D014947:Wounds and Injuries / Q000175:diagnosis / Q000453:epidemiology* / Q000523:psychology*