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Unconsciousness, amnesia and psychiatric symptoms following road traffic accident injury

Department of Psychiatry, University of Oxford

JOHN BLACK, FFAEM

Accident and Emergency Department, John Radcliffe Hospital, Oxford

BRIDGET BRYANT, MSc

Department of Psychiatry, University of Oxford

Correspondence: Professor R. A. Mayou, University of Oxford, Department of Psychiatry, Warneford Hospital, Oxford OX37JX, UK. Tel: 01865 226477; fax: 01865 793101

Declaration of interest The research was supported by a grant from the Wellcome Trust.

Background Although road traffic accident injury is the most common cause of traumatic brain injury, little is known of the prevalence of psychiatric complications or the significance of unconsciousness and amnesia.

Aims To describe amnesia and unconsciousness following a road traffic accident and to determine whether they are associated with later psychological symptoms.

Method Information was obtained from medical and ambulance records for 1441 consecutive attenders at an emergency department aged 17-69 who had been involved in a road traffic accident. A total of 1148 (80%) subjects completed a self-report questionnaire at baseline and were followed up at 3 months and 1 year.

Results Altogether, 1.5% suffered major head (and traumatic brain) injury and 21% suffered minor head injury. Post-traumatic stress disorder (PTSD) and anxiety and depression were more common at 3 months in those who had definitely been unconscious than in those who had not, but there were no differences at 1 year.

Conclusions PTSD and other psychiatric complications are as common in those who were briefly unconscious as in those who were not.

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