PTSD after severe vehicular crashes.
OBJECTIVE
To describe predictors of PTSD after motor vehicle crashes (MVC).


METHODS
MVC patients were interviewed during their hospitalization and at 6 and 12 months post-injury. Interviews included information about behavioral factors, circumstances around the crash, recovery and PTSD screening. PTSD was defined as the development of 3 or more of 7 PTSD symptoms. Association of risk factors with PTSD development at 6 and 12 months was analyzed using contingency tables. Multiple regression models were built for the prediction of PTSD.


RESULTS
367 and 317 patients completed the 6 and 12 month interviews respectively. PTSD developed in 27.5 % (n=101) and 24.3 % (n=77) of the population at 6 and 12 months respectively. PTSD occurred more frequently among females, those with a previous history of depression, violent injury, or other traumatic events, and those whose crashes involved a fatality. Those who were culpable for the crash, age<30, and sustained brain injuries were less likely to develop PTSD at 6 months. Occupant position, education, marital status, alcohol problems, injury severity, heart rate, and blood alcohol + status did not show any significant association with PTSD. In the multiple logistic regression, female gender, history of depression, culpability, prior violent injury, and a fatality in the crash were associated with PTSD at 6 months. Only prior violent injury, and a death in same crash were predictors at one year.


CONCLUSIONS
PTSD occurs frequently after MVCs. Female gender, prior violent injury, death of another occupant and history of depression are associated with PTSD development.
Ryb
Gabriel E
GE
National Study Center for Trauma & EMS, University of Maryland School of Medicine, USA.
Dischinger
Patricia C
PC
Read
Kathleen M
KM
Kufera
Joseph A
JA
D015998:Abbreviated Injury Scale; D000063:Accidents, Traffic / Q000706:statistics & numerical data*; D000223:Adaptation, Psychological; D000328:Adult; D016001:Confidence Intervals; D016208:Databases, Factual; D005260:Female; D006801:Humans; D008297:Male; D008396:Maryland / Q000453:epidemiology; D015233:Models, Statistical; D015999:Multivariate Analysis; D016017:Odds Ratio; D011594:Psychometrics; D012044:Regression Analysis; D012307:Risk Factors; D013313:Stress Disorders, Post-Traumatic / Q000453:epidemiology / Q000209:etiology*; D013315:Stress, Psychological / Q000150:complications*; D014481:United States / Q000453:epidemiology