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Acute stress response and posttraumatic stress disorder in traffic accident victims: a one-year prospective, follow-up study.

Abstract

OBJECTIVE

This study was designed to assess the natural course of posttraumatic symptoms formation, as well as the degree to which acute stress reactions predict later posttraumatic stress disorder (PTSD) in injured traffic accident victims.

METHOD

A prospective, 1-year follow-up study was carried out on 74 injured traffic accident victims and a comparison group of 19 patients who were hospitalized for elective orthopedic surgery. Participants were interviewed within the first week following the accident, and follow-up interviews were performed 1, 3, 6, and 12 months after the accident. At 12 months, a structured clinical interview was administered to determine a formal DSM-III-R diagnosis of PTSD.

RESULTS

Twenty-four (32%) of the 74 traffic accident victims, but none of the 19 comparison subjects, met DSM-III-R criteria for PTSD at 1 year. Traffic accident victims who developed PTSD had higher levels of premorbid and comorbid psychopathology. Levels of posttraumatic symptoms were significantly higher from the outset in the subjects who developed PTSD and worsened progressively over the first 3 months, in contrast to subjects without PTSD, who manifested gradual amelioration of symptoms during this time. Existence of posttraumatic symptoms immediately after the accident was a better predictor of later PTSD than was accident or injury severity.

CONCLUSIONS

In this study, a significant portion of injured traffic accident victims manifested PTSD 1 year after the event. The development of PTSD at 1 year can be predicted as early as 1 week after the accident on the basis of the existence and severity of early PTSD-related symptoms. However, the first 3 months following the accident appear to be the critical period for the development of PTSD.

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  • Publisher Full Text
  • Authors+Show Affiliations

    ,

    Department of Psychiatry of the Rambam Medical Center and the B. Rappaport Faculty of Medicine, Technion, I.I.T., Haifa, Israel.

    ,

    Source

    The American journal of psychiatry 156:3 1999 Mar pg 367-73

    MeSH

    Accidents, Traffic
    Acute Disease
    Adult
    Anxiety Disorders
    Female
    Follow-Up Studies
    Humans
    Male
    Prognosis
    Prospective Studies
    Risk Factors
    Stress Disorders, Post-Traumatic
    Stress, Psychological

    Pub Type(s)

    Journal Article
    Research Support, Non-U.S. Gov't

    Language

    eng

    PubMed ID

    10080550

    Citation

    TY - JOUR T1 - Acute stress response and posttraumatic stress disorder in traffic accident victims: a one-year prospective, follow-up study. AU - Koren,D, AU - Arnon,I, AU - Klein,E, PY - 1999/3/18/pubmed PY - 1999/3/18/medline PY - 1999/3/18/entrez SP - 367 EP - 73 JF - The American journal of psychiatry JO - Am J Psychiatry VL - 156 IS - 3 N2 - OBJECTIVE: This study was designed to assess the natural course of posttraumatic symptoms formation, as well as the degree to which acute stress reactions predict later posttraumatic stress disorder (PTSD) in injured traffic accident victims. METHOD: A prospective, 1-year follow-up study was carried out on 74 injured traffic accident victims and a comparison group of 19 patients who were hospitalized for elective orthopedic surgery. Participants were interviewed within the first week following the accident, and follow-up interviews were performed 1, 3, 6, and 12 months after the accident. At 12 months, a structured clinical interview was administered to determine a formal DSM-III-R diagnosis of PTSD. RESULTS: Twenty-four (32%) of the 74 traffic accident victims, but none of the 19 comparison subjects, met DSM-III-R criteria for PTSD at 1 year. Traffic accident victims who developed PTSD had higher levels of premorbid and comorbid psychopathology. Levels of posttraumatic symptoms were significantly higher from the outset in the subjects who developed PTSD and worsened progressively over the first 3 months, in contrast to subjects without PTSD, who manifested gradual amelioration of symptoms during this time. Existence of posttraumatic symptoms immediately after the accident was a better predictor of later PTSD than was accident or injury severity. CONCLUSIONS: In this study, a significant portion of injured traffic accident victims manifested PTSD 1 year after the event. The development of PTSD at 1 year can be predicted as early as 1 week after the accident on the basis of the existence and severity of early PTSD-related symptoms. However, the first 3 months following the accident appear to be the critical period for the development of PTSD. SN - 0002-953X UR - https://www.unboundmedicine.com/medline/citation/10080550/Acute_stress_response_and_posttraumatic_stress_disorder_in_traffic_accident_victims:_a_one_year_prospective_follow_up_study_ L2 - http://psychiatryonline.org/doi/abs/10.1176/ajp.156.3.367?url_ver=Z39.88-2003&rfr_id=ori:rid:crossref.org&rfr_dat=cr_pub=pubmed ER -