Posttraumatic stress disorder symptom trajectories within the first year following emergency department admissions: pooled results from the International Consortium to predict PTSD

Abstract

Background Research exploring the longitudinal course of posttraumatic stress disorder (PTSD) symptoms has documented four modal trajectories (low, remitting, high, and delayed), with proportions varying across studies. Heterogeneity could be due to differences in trauma types and patient demographic characteristics. Methods This analysis pooled data from six longitudinal studies of adult survivors of civilian-related injuries admitted to general hospital emergency departments (EDs) in six countries (pooled N = 3083). Each study included at least three assessments of the clinician-administered PTSD scale in the first post-trauma year. Latent class growth analysis determined the proportion of participants exhibiting various PTSD symptom trajectories within and across the datasets. Multinomial logistic regression analyses examined demographic characteristics, type of event leading to the injury, and trauma history as predictors of trajectories differentiated by their initial severity and course. Results Five trajectories were found across the datasets: Low (64.5%), Remitting (16.9%), Moderate (6.7%), High (6.5%), and Delayed (5.5%). Female gender, non-white race, prior interpersonal trauma, and assaultive injuries were associated with increased risk for initial PTSD reactions. Female gender and assaultive injuries were associated with risk for membership in the Delayed (v. Low) trajectory, and lower education, prior interpersonal trauma, and assaultive injuries with risk for membership in the High (v. Remitting) trajectory. Conclusions The results suggest that over 30% of civilian-related injury survivors admitted to EDs experience moderate-to-high levels of PTSD symptoms within the first post-trauma year, with those reporting assaultive violence at increased risk of both immediate and longer-term symptoms.

COVID-19 Pandemic in the Italian Population: Validation of a Post-Traumatic Stress Disorder Questionnaire and Prevalence of PTSD Symptomatology

“…As evidenced by previous studies, PTSD is reported in epidemics or other medical emergencies [11][12][13][14] in the months following the critical period. Moreover, PTSD symptoms were reported in the first studies of the COVID-19 emergency in China and Italy [5,6,15].…”

Prior sleep problems and adverse post-traumatic neuropsychiatric sequelae of motor vehicle collision in the AURORA study

“…Third, the decision to carry out short-term follow-ups at 2 and 8 weeks was relatively arbitrary and resulted in not being able to detect DSM PTSD as of 1 month that remitted before 8 weeks. Some other prospective studies can do this because they included a 1-month assessment [74]. However, we are administering short smart phone symptom surveys to all respondents each day for the first 8 weeks after trauma exposure, allowing us to capture symptoms of PTSD and MDE in a more granular fashion.…”

Socio-demographic and trauma-related predictors of PTSD within 8 weeks of a motor vehicle collision in the AURORA study

“…Fourth, the decision to carry out short-term follow-up surveys at 2 and 8 weeks were relatively arbitrary and resulted in the surveys not being able to detect instances when patients met DSM criteria for PTSD as of 1 month but remitted before the 8-week assessment. Many other prospective studies of PTSD among ED patients can do this because they include a 1-month assessment [ 34 ] in order to address the DSM requirement that symptoms persist more than 1 month to qualify for a diagnosis of PTSD. However, AURORA administers short smart phone symptom surveys to all respondents each day for 8 weeks.…”