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Post-traumatic stress disorder in serious accidental injury: 3-year follow-up study

Psychiatrische Dienste Aargau AG, Baden, and Department of Psychiatry, University Hospital Zurich, Switzerland

Hanspeter Moergeli, PhD and Stefan Buchi, MD

Department of Psychiatry, University Hospital Zurich, Switzerland

Helke Bruchhaus-Steinert, MD

Institute for Ecological Systemic Therapy, Zurich, Switzerland

Bernd Kraemer, MD

Department of Psychiatry, University Hospital Zurich, Switzerland

Tom Sensky, FRCPsych

Division of Neurosciences and Psychological Medicine, Imperial College School of Medicine, London, UK

Ulrich Schnyder, MD

Department of Psychiatry, University Hospital Zurich, Switzerland

Correspondence: Dr Urs Hepp, Psychiatrische Dienste Aargau AG, Haselstrasse 1, CH-5401 Baden, Switzerland. Email: Urs.Hepp{at}pdag.ch

Declaration of interest

None. Funding detailed in Acknowledgements.

Background

Long-term data on post-traumatic stress disorder (PTSD) following accidents are scarce.

Aims

To assess and predict PTSD in people 3 years after severe accidental injury.

Method

Severely injured patients were recruited consecutively from the intensive care unit (n=121) and assessed within 1 month of the trauma. Follow-up interviews were conducted 6 months, 12 months and 36 months later; 90 patients participated in all four interviews. Symptoms were assessed using the Clinician-Administered PTSD Scale.

Results

Post-traumatic stress disorder was diagnosed in 6% of patients 2 weeks after the accident, in 2% after 1 year and in 4% after 3 years. Robust predictors of later PTSD symptom level were intrusive symptoms shortly after the accident and biographical risk factors. There were individual changes over time between the categories PTSD, sub-threshold PTSD and no PTSD. Whereas PTSD symptom severity was low or decreased for most of the patients, some of them showed an increase or a delayed onset. Patients with persisting PTSD symptoms at 6 months and patients with delayed onset of symptoms are at risk of long-term PTSD.

Conclusions

The prevalence of PTSD was low over the whole period of 3 years.