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

Schnyder, Ulrich; Moergeli, Hanspeter; Klaghofer, Richard; Buddeberg, Claus

doi:10.1176/appi.ajp.158.4.594

Cited by 227 publications

(169 citation statements)

References 36 publications

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“…Nach 6 Monaten werden noch in 5-25% posttraumatische Belastungsstörungen beobachtet (Brom et al 1993;Feinstein and Dolan 1991;Mayou et al 1993;Ursano et al 1999). Auch im längerfristigen Verlauf wurden ähnliche Inzidenzraten beschrieben (Koren et al 1999;Malt 1988;Malt et al 1989;Mayou et al 2001;Schnyder et al 2001a). Fünf Jahre nach einem Unfall haben immerhin noch 8% eine chronische posttraumatische Belastungsstörung (Mayou et al 1997).…”

Section: Zur Häufigkeit Posttraumatischer Belastungsstörungen Nach Ununclassified

“…Die emotionalen und kognitiven Reaktionen, die bei den Betroffenen während und unmittelbar nach dem Unfall ablaufen, spielen eine entscheidende Rolle für die Traumaverarbeitung: Die subjektiv erlebte Bedrohung, die oft keineswegs mit den objektiven Unfall-und Verletzungsparametern korreliert, ist einer der robustesten Prädiktoren für die Entstehung der posttraumatischen Belastungsstörung (Blanchard et al 1995;Liegey Dougall et al 2001;Mayou et al 2001;Schnyder et al 2001a). Andererseits haben Patienten, die die Verantwortung für den Unfall sich selber zuschreiben, ein geringeres Risko, später an einer posttraumatischen Belastungsstörung zu erkranken (Delahanty et al 1997;Hickling et al 1999).…”

Section: Früherkennung: Worauf Muss Der Chirurg Achten?unclassified

“…Auch früh einsetzende psychopathologische Symptome des Wiederlebens wie z.B. Flashbacks sind Risikofaktoren für die spätere Entwicklung einer posttraumatischen Belastungsstörung (Blanchard et al 1996;Schnyder et al 2001a). Schliesslich sei noch erwähnt, dass auch das Ausmass der Schmerzen in den ersten Tagen nach dem Unfall einen Einfluss auf die Entwicklung posttraumatischer psychischer Störungen hat (Fuglsang et al 2002).…”

Section: Früherkennung: Worauf Muss Der Chirurg Achten?unclassified

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Posttraumatische Belastungsstörungen

Schnyder¹

2003

Praxis

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Plus de la moitié des gens présentent durant leur vie au moins une expérience traumatique selon la définition de la psychotraumatologie moderne. Une partie des personnes concernées développent ensuite des troubles psychiques post-traumatiques. Les critères diagnostiques de la réaction psychique aiguë ainsi que les troubles durables de la personnalité sont présentés dans ce travail. Les troubles psychiques post-traumatiques doivent être traités en première intention par psychothérapie. Les traitements basés sur une approche cognitive et comportementale ont actuellement les meilleurs effets thérapeutiques. Il n'est pas rare que des médicaments psychotropes soient nécessaires. Les antidépresseurs agissant sur les récepteurs à sérotonine sont les médicaments de premier choix. Les benzodiazépines ne devraient être utilisées qu'avec la plus grande réserve en raison des risques élevés de dépendance. Finalement, ce travail présente les facteurs prédictifs qui peuvent faciliter l'identification de patients à risque psycho-social.

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Section: Zur Häufigkeit Posttraumatischer Belastungsstörungen Nach Ununclassified

Section: Früherkennung: Worauf Muss Der Chirurg Achten?unclassified

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Posttraumatische Belastungsstörungen

Schnyder¹

2003

Praxis

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“…Acute-care based studies to date have identified several predictors of PTSD that are accessible in the early aftermath of trauma exposure, including lifetime trauma exposure, disadvantaged socio-demographic background, event severity, and early PTSD symptoms (Ehlers, Mayou, & Bryant, 2003; Freedman, Brandes, Peri, & Shalev, 1999; Karstoft, Galatzer-Levy, Statnikov, Li, & Shalev, 2015; Schnyder, Moergeli, Klaghofer, & Buddeberg, 2001; Shah & Vaccarino, 2015; Shalev, Freedman, Peri, Brandes, & Sahar, 1997; Shalev, Peri, Canetti, & Schreiber, 1996). However, differences in the design, location, sampling, measurements, and length of follow-up of these studies has precluded the development of a generalizable predictive model (Bryant, Creamer, O’Donnell, Silove, & McFarlane, 2012; Bryant et al, 2015; Ehlers, Mayou, & Bryant, 1998; Heron-Delaney, Kenardy, Charlton, & Matsuoka, 2013; Schnyder et al, 2001).…”

Section: Introductionmentioning

confidence: 99%

“…However, differences in the design, location, sampling, measurements, and length of follow-up of these studies has precluded the development of a generalizable predictive model (Bryant, Creamer, O’Donnell, Silove, & McFarlane, 2012; Bryant et al, 2015; Ehlers, Mayou, & Bryant, 1998; Heron-Delaney, Kenardy, Charlton, & Matsuoka, 2013; Schnyder et al, 2001). …”

Section: Introductionmentioning

confidence: 99%

Application of data pooling to longitudinal studies of early post-traumatic stress disorder (PTSD): the International Consortium to Predict PTSD (ICPP) project

Ratanatharathorn

Gevonden

et al. 2018

European Journal of Psychotraumatology

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Background: Understanding the development of post-traumatic stress disorder (PTSD) is a precondition for efficient risk assessment and prevention planning. Studies to date have been site and sample specific. Towards developing generalizable models of PTSD development and prediction, the International Consortium to Predict PTSD (ICPP) compiled data from 13 longitudinal, acute-care based PTSD studies performed in six different countries.Objective: The objectives of this study were to describe the ICPP’s approach to data pooling and harmonization, and present cross-study descriptive results informing the longitudinal course of PTSD after acute trauma.Methods: Item-level data from 13 longitudinal studies of adult civilian trauma survivors were collected. Constructs (e.g. PTSD, depression), measures (questions or scales), and time variables (days from trauma) were identified and harmonized, and those with inconsistent coding (e.g. education, lifetime trauma exposure) were recoded. Administered in 11 studies, the Clinician Administered PTSD Scale (CAPS) emerged as the main measure of PTSD diagnosis and severity.Results: The pooled data set included 6254 subjects (39.9% female). Studies’ average retention rate was 87.0% (range 49.1–93.5%). Participants’ baseline assessments took place within 2 months of trauma exposure. Follow-up durations ranged from 188 to 1110 days. Reflecting studies’ inclusion criteria, the prevalence of baseline PTSD differed significantly between studies (range 3.1–61.6%), and similar differences were observed in subsequent assessments (4.3–38.2% and 3.8–27.0% for second and third assessments, respectively).Conclusion: Pooling data from independently collected studies requires careful curation of individual data sets for extracting and optimizing informative commonalities. However, it is an important step towards developing robust and generalizable prediction models for PTSD and can exceed findings of single studies. The large differences in prevalence of PTSD longitudinally cautions against using any individual study to infer trauma outcome. The multiplicity of instruments used in individual studies emphasizes the need for common data elements in future studies.

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Multisite Investigation of Traumatic Brain Injuries, Posttraumatic Stress Disorder, and Self-reported Health and Cognitive Impairments

Zatzick

Rivara

Jurkovich

et al. 2010

Arch Gen Psychiatry

102

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Context Few large-scale, multisite investigations have assessed the development of posttraumatic stress disorder (PTSD) symptoms and health outcomes across the spectrum of patients with mild, moderate, and severe traumatic brain injury (TBI). Objectives To understand the risk of developing PTSD symptoms and to assess the impact of PTSD on the development of health and cognitive impairments across the full spectrum of TBI severity. Design Multisite US prospective cohort study. Setting Eighteen level I trauma centers and 51 non–trauma center hospitals. Patients A total of 3047 (weighted n=10 372) survivors of multiple traumatic injuries between the ages of 18 and 84 years. Main Outcome Measures Severity of TBI was categorized from chart-abstracted International Classification of Diseases, Ninth Revision, Clinical Modification codes. Symptoms consistent with a DSM-IV diagnosis of PTSD were assessed with the PTSD Checklist 12 months after injury. Self-reported outcome assessment included the 8 Medical Outcomes Study 36-Item Short Form Health Survey health status domains and a 4-item assessment of cognitive function at telephone interviews 3 and 12 months after injury. Results At the time of injury hospitalization, 20.5% of patients had severe TBI, 11.7% moderate TBI, 12.9% mild TBI, and 54.9% no TBI. Patients with severe (relative risk, 0.72; 95% confidence interval, 0.58-0.90) and moderate (0.63; 0.44-0.89) TBI, but not mild TBI (0.83; 0.61-1.13), demonstrated a significantly diminished risk of PTSD symptoms relative to patients without TBI. Across TBI categories, in adjusted analyses patients with PTSD demonstrated an increased risk of health status and cognitive impairments when compared with patients without PTSD. Conclusions More severe TBI was associated with a diminished risk of PTSD. Regardless of TBI severity, injured patients with PTSD demonstrated the greatest impairments in self-reported health and cognitive function. Treatment programs for patients with the full spectrum of TBI severity should integrate intervention approaches targeting PTSD.

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

Abstract: 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.

Cited by 227 publications

References 36 publications

Posttraumatische Belastungsstörungen

Posttraumatische Belastungsstörungen

Application of data pooling to longitudinal studies of early post-traumatic stress disorder (PTSD): the International Consortium to Predict PTSD (ICPP) project

Multisite Investigation of Traumatic Brain Injuries, Posttraumatic Stress Disorder, and Self-reported Health and Cognitive Impairments

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