Incidence and Prediction of Posttraumatic Stress Disorder Symptoms in Severely Injured Accident Victims

TLDR

The study aimed to determine the incidence of PTSD in severely injured accident victims and to predict PTSD symptoms at 12 months post‑injury. Patients were interviewed at 1 month and 12 months post‑accident using structured clinical interviews and validated questionnaires (Impact of Event Scale, Clinician‑Administered PTSD Scale, Sense of Coherence, Freiburg Coping Questionnaire). At 1 month, 4.7 % met full PTSD criteria and 20.8 % had subsyndromal symptoms; at 1 year, 1.9 % had PTSD and 12.3 % subsyndromal, with 34 % of 12‑month symptom variance explained by biographical risk factors, perceived death threat, intrusion symptoms, and problem‑oriented coping.

Abstract

This study was designed to assess the incidence of posttraumatic stress disorder (PTSD) in severely injured accident victims and to predict the presence of PTSD symptoms at a 12-month follow-up.A longitudinal, 1-year follow-up study was carried out with 106 consecutive patients with severe accidental injuries who were admitted to the trauma surgeons' intensive care unit at a university hospital. Patients were interviewed within 1 month and 12 months after the accident. Assessments included an extensive clinical interview, the Impact of Event Scale, the Clinician-Administered PTSD Scale, the Sense of Coherence questionnaire, and the Freiburg Questionnaire of Coping With Illness.A total of 13.4 days (SD=6.6) after the accident, five patients (4.7%) met all criteria for PTSD with the exception of the time criterion. A total of 22 other patients (20.8%) had subsyndromal PTSD. At the 1-year follow-up, two patients (1.9%) had PTSD, and 13 (12.3%) had subsyndromal PTSD. Multiple regression analysis explained 34% of the variance of PTSD symptoms 12 months after the accident. Biographical risk factors, the sense of a death threat, symptoms of intrusion, and problem-oriented coping each contributed significantly to the predictive model.In severely injured accident victims who were healthy before experiencing trauma, the incidence of PTSD was low. One-third of the variance of PTSD symptoms at 1-year follow-up could be predicted by mainly psychosocial variables.