A longitudinal analysis of alcohol consumption and the risk of posttraumatic symptoms.
BACKGROUND
Previous studies investigating the impact of alcohol ingestion on the emergence of posttraumatic psychological symptoms have generated contradictory findings.


METHODS
One thousand forty-five patients, admitted to hospital following traumatic injury were assessed during hospitalisation for patterns of alcohol consumption prior to the injury and also during the month prior to reassessment at 3 months. Anxiety, depression and posttraumatic stress disorder (PTSD) were assessed post accident and at 3 months. In a sub sample (n=167), blood alcohol levels were measured at the time of admission to emergency departments.


RESULTS
Moderate alcohol consumption prior to and following the accident predicted lower levels of psychological distress at 1 week and 3 months. No significant relationship was found between the blood alcohol level and psychiatric outcomes. PTSD predicted the emergence of alcohol abuse following the accident, suggesting self-medication in a subgroup of survivors.


CONCLUSIONS
The impact of alcohol consumption upon injury severity and the nature of injury was not controlled for and some non-participation may have been related to patterns of alcohol consumption. We relied on retrospective reports of alcohol use obtained shortly after the traumatic injury to index prior alcohol use and these reports may have been influenced by mood states at the time of recall. Our follow-up was limited to 3 months and there is a need for longer-term assessment of the relationship between prior alcohol use and subsequent posttraumatic adjustment.


CONCLUSIONS
Given the potential impact of alcohol use on traumatic injury and post-injury recovery, we advocate active screening and early intervention strategies that focus on moderate alcohol usage.
McFarlane
A C
AC
Centre for Military and Veterans' Health, University of Adelaide, South Australia, Australia. alexander.mcfarlane@adelaide.edu.au
Browne
D
D
Bryant
R A
RA
O'Donnell
M
M
Silove
D
D
Creamer
M
M
Horsley
K
K
D000058:Accidental Falls; D000063:Accidents, Traffic / Q000523:psychology*; D000223:Adaptation, Psychological; D000328:Adult; D000435:Alcoholic Intoxication / Q000453:epidemiology* / Q000523:psychology; D000437:Alcoholism / Q000453:epidemiology / Q000523:psychology; D001008:Anxiety Disorders / Q000175:diagnosis / Q000453:epidemiology / Q000523:psychology; D001315:Australia; D001930:Brain Injuries / Q000453:epidemiology / Q000523:psychology; D039721:Diagnostic and Statistical Manual of Mental Disorders; D000431:Ethanol / Q000097:blood; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D015601:Injury Severity Score; D007406:Interview, Psychological; D008297:Male; D008403:Mass Screening; D008875:Middle Aged; D012306:Risk; D013313:Stress Disorders, Post-Traumatic / Q000175:diagnosis / Q000453:epidemiology* / Q000523:psychology; D013695:Temperance / Q000523:psychology; D014947:Wounds and Injuries / Q000453:epidemiology* / Q000523:psychology
D000431:Ethanol