Post-traumatic stress disorder in serious accidental injury: 3-year follow-up study.
BACKGROUND
Long-term data on post-traumatic stress disorder (PTSD) following accidents are scarce.


OBJECTIVE
To assess and predict PTSD in people 3 years after severe accidental injury.


METHODS
Severely injured patients were recruited consecutively from the intensive care unit (n=121) and assessed within 1 month of the trauma. Follow-up interviews were conducted 6 months, 12 months and 36 months later; 90 patients participated in all four interviews. Symptoms were assessed using the Clinician-Administered PTSD Scale.


RESULTS
Post-traumatic stress disorder was diagnosed in 6% of patients 2 weeks after the accident, in 2% after 1 year and in 4% after 3 years. Robust predictors of later PTSD symptom level were intrusive symptoms shortly after the accident and biographical risk factors. There were individual changes over time between the categories PTSD, sub-threshold PTSD and no PTSD. Whereas PTSD symptom severity was low or decreased for most of the patients, some of them showed an increase or a delayed onset. Patients with persisting PTSD symptoms at 6 months and patients with delayed onset of symptoms are at risk of long-term PTSD.


CONCLUSIONS
The prevalence of PTSD was low over the whole period of 3 years.
Hepp
Urs
U
Psychiatrische Dienste Aargau AG, Baden, Switzerland. Urs.Hepp@pdag.ch
Moergeli
Hanspeter
H
Buchi
Stefan
S
Bruchhaus-Steinert
Helke
H
Kraemer
Bernd
B
Sensky
Tom
T
Schnyder
Ulrich
U
D000059:Accidents / Q000523:psychology* / Q000706:statistics & numerical data; D000293:Adolescent; D000328:Adult; D000368:Aged; D004812:Epidemiologic Methods; D005260:Female; D006801:Humans; D007362:Intensive Care Units; D008297:Male; D001523:Mental Disorders / Q000453:epidemiology / Q000523:psychology; D008875:Middle Aged; D011569:Psychiatric Status Rating Scales; D013313:Stress Disorders, Post-Traumatic / Q000453:epidemiology* / Q000523:psychology; D013557:Switzerland / Q000453:epidemiology; D013997:Time Factors