OBJECTIVE: Each year approximately 2.5 million Americans are hospitalized after sustaining traumatic physical injuries. Few investigations have comprehensively screened for posttraumatic symptomatic distress or identified predictors of posttraumatic stress disorder (PTSD) in representative samples of surgical inpatients. METHOD: The subjects were 101 randomly selected survivors of motor vehicle crashes or assaults who were interviewed while hospitalized and 1, 4, and 12 months after injury. In the surgical ward, inpatients were screened for PTSD, depressive, and dissociative symptoms, for prior trauma, for pre-event functioning, and for alcohol and drug intoxication. Patient demographic and injury characteristics were also recorded. Random coefficient regression models were used to assess the association between these clinical, injury, and demographic characteristics and PTSD symptom levels over the year after the injury. RESULTS: Of the 101 surgical inpatients, 73% screened positive for high levels of symptomatic distress and/or substance intoxication. At 1, 4, and 12 months after the injury, 30%-40% reported symptoms consistent with a diagnosis of PTSD. High ward PTSD symptom levels were the strongest and most parsimonious predictor of persistent symptoms over the course of the year. Greater prior trauma, stimulant intoxication, and female gender were also associated with higher symptom levels. Increasing injury severity, however, was not associated with higher PTSD symptom levels. CONCLUSIONS: Clinical and demographic characteristics readily identifiable at the time of surgical inpatient hospitalization predict PTSD symptoms over the year after injury. Effectiveness trials that test screening and intervention procedures for at-risk inpatients should be developed.
OBJECTIVE: Each year approximately 2.5 million Americans are hospitalized after sustaining traumatic physical injuries. Few investigations have comprehensively screened for posttraumatic symptomatic distress or identified predictors of posttraumatic stress disorder (PTSD) in representative samples of surgical inpatients. METHOD: The subjects were 101 randomly selected survivors of motor vehicle crashes or assaults who were interviewed while hospitalized and 1, 4, and 12 months after injury. In the surgical ward, inpatients were screened for PTSD, depressive, and dissociative symptoms, for prior trauma, for pre-event functioning, and for alcohol and drug intoxication. Patient demographic and injury characteristics were also recorded. Random coefficient regression models were used to assess the association between these clinical, injury, and demographic characteristics and PTSD symptom levels over the year after the injury. RESULTS: Of the 101 surgical inpatients, 73% screened positive for high levels of symptomatic distress and/or substance intoxication. At 1, 4, and 12 months after the injury, 30%-40% reported symptoms consistent with a diagnosis of PTSD. High ward PTSD symptom levels were the strongest and most parsimonious predictor of persistent symptoms over the course of the year. Greater prior trauma, stimulant intoxication, and female gender were also associated with higher symptom levels. Increasing injury severity, however, was not associated with higher PTSD symptom levels. CONCLUSIONS: Clinical and demographic characteristics readily identifiable at the time of surgical inpatient hospitalization predict PTSD symptoms over the year after injury. Effectiveness trials that test screening and intervention procedures for at-risk inpatients should be developed.
Authors: J Randall Curtis; Paul S Ciechanowski; Lois Downey; Julia Gold; Elizabeth L Nielsen; Sarah E Shannon; Patsy D Treece; Jessica P Young; Ruth A Engelberg Journal: Contemp Clin Trials Date: 2012-07-06 Impact factor: 2.226
Authors: James A Fauerbach; Jodi McKibben; O Joseph Bienvenu; Gina Magyar-Russell; Michael T Smith; Radha Holavanahalli; David R Patterson; Shelley A Wiechman; Patricia Blakeney; Dennis Lezotte Journal: Psychosom Med Date: 2007-06 Impact factor: 4.312
Authors: Elie George Karam; Gavin Andrews; Evelyn Bromet; Maria Petukhova; Ayelet Meron Ruscio; Mariana Salamoun; Nancy Sampson; Dan J Stein; Jordi Alonso; Laura Helena Andrade; Matthias Angermeyer; Koen Demyttenaere; Giovanni de Girolamo; Ron de Graaf; Silvia Florescu; Oye Gureje; Debra Kaminer; Roman Kotov; Sing Lee; Jean-Pierre Lépine; Maria Elena Medina-Mora; Mark A Oakley Browne; José Posada-Villa; Rajesh Sagar; Arieh Y Shalev; Tadashi Takeshima; Toma Tomov; Ronald C Kessler Journal: Biol Psychiatry Date: 2010-09-01 Impact factor: 13.382
Authors: Brian E Bunnell; Tatiana M Davidson; Jennifer R Winkelmann; Jessica L Maples-Keller; Leigh E Ridings; Jennifer Dahne; Samir M Fakhry; Kenneth J Ruggiero Journal: Telemed J E Health Date: 2019-02-07 Impact factor: 3.536