title: Stepped early psychological intervention for posttraumatic stress disorder, other anxiety disorders, and depression following serious injury.
abstract: The best approach for implementing early psychological intervention for anxiety and depressive disorders after a traumatic event has not been established. This study aimed to test the effectiveness of a stepped model of early psychological intervention following traumatic injury. A sample of 683 consecutively admitted injury patients were screened during hospitalization. High-risk patients were followed up at 4-weeks postinjury and assessed for anxiety and depression symptom levels. Patients with elevated symptoms were randomly assigned to receive 4-10 sessions of cognitive-behavioral therapy (n = 24) or usual care (n = 22). Screening in the hospital identified 89% of those who went on to develop any anxiety or affective disorder at 12 months. Relative to usual care, patients receiving early intervention had significantly improved mental health at 12 months. A stepped model can effectively identify and treat injury patients with high psychiatric symptoms within 3 months of the initial trauma.
authors.affiliation: Australian Centre for Posttraumatic Mental Health, East Melbourne Victoria, Australia. mod@unimelb.edu.au
authors.forename: Meaghan L
authors.initials: ML
authors.lastname: O'Donnell
authors.forename: Winnie
authors.initials: W
authors.lastname: Lau
authors.forename: Susannah
authors.initials: S
authors.lastname: Tipping
authors.forename: Alexander C N
authors.initials: AC
authors.lastname: Holmes
authors.forename: Steven
authors.initials: S
authors.lastname: Ellen
authors.forename: Rodney
authors.initials: R
authors.lastname: Judson
authors.forename: Tracey
authors.initials: T
authors.lastname: Varker
authors.forename: Peter
authors.initials: P
authors.lastname: Elliot
authors.forename: Richard A
authors.initials: RA
authors.lastname: Bryant
authors.forename: Mark C
authors.initials: MC
authors.lastname: Creamer
authors.forename: David
authors.initials: D
authors.lastname: Forbes
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D001008:Anxiety Disorders / Q000628:therapy*; D015928:Cognitive Behavioral Therapy; D003863:Depression / Q000628:therapy*; D005260:Female; D006760:Hospitalization; D006801:Humans; D007407:Interviews as Topic; D008297:Male; D008875:Middle Aged; D011613:Psychotherapy; D012720:Severity of Illness Index; D013313:Stress Disorders, Post-Traumatic / Q000175:diagnosis / Q000628:therapy*; D014739:Victoria; D014947:Wounds and Injuries / Q000523:psychology*; D055815:Young Adult