title: Post-traumatic stress symptoms in relatives in the first weeks after severe traumatic brain injury.
abstract: BACKGROUND
  Severe traumatic brain injury (STBI) can cause psychological stress in proxies in the long-term. This study assessed post-traumatic stress (PTS) symptoms in proxies of survivors of STBI in the short-term and investigated stress-associated factors.
  
  
  METHODS
  Prospective cross-sectional study, conducted at three Swiss trauma centres over 1 year. Patient and proxy demographics, trauma data including Glasgow Coma Scale (GCS) and management data were collected. The proxies' PTS symptoms were assessed by applying the Impact of Event Scale-Revised (IES-R), once in the first month after the accident (median: 11 days).
  
  
  RESULTS
  Sixty-nine proxies were included; 52 proxies were female (77.8%). Mean IES-R sum score for intrusions was 13.38 (SD=7.26), for avoidance 8.91 (SD=5.94), and for hyperarousal 9.07 (SD=6.75). Clinically significant PTS symptoms were observed in 36 proxies (52.2%); mean IES-R sum scores were significantly higher in women. IES-R sub-scale values were inversely related with GCS at the scene of the accident and on hospital admission.
  
  
  CONCLUSIONS
  More than half of proxies had clinically significant PTS symptoms shortly after their relative's accident. More severe PTS symptoms were found in women and in proxies of patients with poorer initial GCS scores. Further research into risk groups in the short- and long-term and the long-term impact on patients of PTS syndrome in proxies is warranted.
authors.affiliation: Department of Psychopathology and Clinical Intervention, Institute of Psychology, University of Zurich, Zurich, Switzerland. l.pielmaier@psychologie.uzh.ch
authors.forename: Laura
authors.initials: L
authors.lastname: Pielmaier
authors.forename: Bernhard
authors.initials: B
authors.lastname: Walder
authors.forename: Marie My Lien
authors.initials: MM
authors.lastname: Rebetez
authors.forename: Andreas
authors.initials: A
authors.lastname: Maercker
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000704:Analysis of Variance; D001930:Brain Injuries / Q000523:psychology*; D002648:Child; D002675:Child, Preschool; D016000:Cluster Analysis; D005190:Family / Q000523:psychology*; D005260:Female; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D008297:Male; D008875:Middle Aged; D019727:Proxy / Q000523:psychology*; D013313:Stress Disorders, Post-Traumatic / Q000175:diagnosis / Q000523:psychology*; D013315:Stress, Psychological; D013997:Time Factors; D015599:Trauma Severity Indices; D055815:Young Adult