title: Investigation of posttraumatic stress disorder in children after animal-induced injury in China.
abstract: OBJECTIVE
  Dogs are important members of many families in many countries. However, posttraumatic stress disorder (PTSD) in children after animal attacks has always been underestimated, and a more-detailed study of PTSD in children after animal attacks is needed.
  
  
  METHODS
  The charts and follow-up data for 358 children after animal-induced injuries were reviewed. Family Apgar Scale assessment and PTSD screening were performed at emergency department admission. On week 1 after the emergency department admission, the patient underwent evaluation for acute stress disorder (ASD) diagnosis, by using the Child Acute Stress Questionnaire. PTSD screening and interim history-taking were performed 3 months after the emergency department admission, by telephone or in face-to-face interviews, by using the Clinician-Administered PTSD Scale for Children and Adolescents. P values of <.05 were considered significant.
  
  
  RESULTS
  A total of 19 patients developed PTSD, including 10 patients with severe injuries, 8 patients with moderate injuries, and 1 patient with a mild injury (chi(2)=48.104; P=.000). No significant differences in PTSD occurrence according to gender and age were observed. Family Apgar Scale scores were not significantly related to PTSD (P=.781). ASD and PTSD symptom severity scores were significantly associated (r=0.51; P < .005).
  
  
  CONCLUSIONS
  Child victims of severe animal attacks should be considered at risk for the development of PTSD, family support was not correlated with posttraumatic stress symptoms in school-aged children after animal attacks, and ASD seems to be an early predictive indicator of PTSD.
authors.affiliation: Department of Pediatrics, Peking Union Medical College Hospital, Peking Union Medical College, Chinese Academy of Medical Sciences, Beijing, China. lijiatpumh@126.com
authors.forename: Li
authors.initials: L
authors.lastname: Ji
authors.forename: Zhang
authors.initials: Z
authors.lastname: Xiaowei
authors.forename: Wang
authors.initials: W
authors.lastname: Chuanlin
authors.forename: Liu
authors.initials: L
authors.lastname: Wei
mesh_terms: D000293:Adolescent; D000818:Animals; D001733:Bites and Stings / Q000523:psychology*; D002648:Child; D002675:Child, Preschool; D002681:China / Q000453:epidemiology; D004285:Dogs; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D012720:Severity of Illness Index; D013313:Stress Disorders, Post-Traumatic / Q000175:diagnosis / Q000453:epidemiology* / Q000209:etiology*; D040701:Stress Disorders, Traumatic, Acute / Q000175:diagnosis / Q000453:epidemiology* / Q000209:etiology*; D011795:Surveys and Questionnaires