Hostname: page-component-7479d7b7d-c9gpj Total loading time: 0 Render date: 2024-07-10T22:51:27.909Z Has data issue: false hasContentIssue false

Psychiatric disorders after an accident: Predictors and the influence of the psychiatric condition prior to an accident

Published online by Cambridge University Press:  16 April 2020

Marco Wrenger*
Affiliation:
Department of Psychosomatics and Psychotherapy, University Hospital Münster, Domagkstraße 22, D-48149Münster, Germany
Corinna Lange
Affiliation:
Department of Psychosomatics and Psychotherapy, University Hospital Münster, Domagkstraße 22, D-48149Münster, Germany
Martin Langer
Affiliation:
Department of Traumatic, Hand and Reconstructive Surgery, University Hospital Münster, Waldeyerstraße 1, D-48149Münster, Germany
Gereon Heuft
Affiliation:
Department of Psychosomatics and Psychotherapy, University Hospital Münster, Domagkstraße 22, D-48149Münster, Germany
Markus Burgmer
Affiliation:
Department of Psychosomatics and Psychotherapy, University Hospital Münster, Domagkstraße 22, D-48149Münster, Germany
*
*Corresponding author. Tel.: +49 251 835 2905; fax: +49 251 835 2903. E-mail address: marco.wrenger@ukmuenster.de (M. Wrenger).
Get access

Abstract

Background

The goal of this study is to assess prevalence and incidence of psychiatric sequelae in a sample of inpatient accident survivors. Such an attempt to assess psychiatric conditions that originate due to an accident seems to be important; this does not include psychiatric conditions already present prior to the accident.

Method

208 accident victims were consecutively examined over a period of 12 months using DSM-IV diagnostic assessment, CAPS, and self-evaluating questionnaires as well as ISS for injury severity. A predictor model for psychiatric disorders was set up.

Results

Incidence of newly developed Axis I disorders in our sample was 14.2% (6 months) and 12.3% (12 months). Incidence of PTSD was 5.9% (6 months) and 2.5% (12 months). Comorbidity was a general phenomenon. The psychiatric condition prior to the accident could be identified as a predictor for the development of Axis I disorders. The subjectively evaluated intensity of experienced threat to life and female gender were the main predictors for the development of PTSD.

Conclusions

Accidents can lead to different psychiatric disorders. PTSD as a single diagnosis is rare. Without taking into account pre-existing disorders, the incidence may be overestimated. Two predictor models for the development of PTSD and other mental disorders are presented.

Type
Original article
Copyright
Copyright © Elsevier Masson SAS 2008

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

American Psychiatric Association, Diagnostic and statistical manual for mental disorders 4th ed. 1994 American Psychiatric Association Washington, DC, APAGoogle Scholar
Blake, D.D.Weathers, F.W.Nagy, L.M.Kaloupek, D.G.Gusman, F.D.Charney, D.D.et al.The development of a Clinician – Administered PTSD Scale J Trauma Stress. 8 1 1995 7590CrossRefGoogle ScholarPubMed
Blanchard, E.B.Hickling, E.J.Taylor, A.E.Loos, W.R.Forneris, C.A.Jaccard, J.Who develops PTSD from motor vehicle accidents? Behav Res Ther. 34 1 1996 110CrossRefGoogle ScholarPubMed
Blanchard, E.B.Hickling, E.J.Barton, K.A.Taylor, A.E.Loos, W.R.Jones-Alexander, J.One-year prospective follow-up of motor vehicle accident victims Behav Res Ther. 34 10 1996 775786CrossRefGoogle ScholarPubMed
Blanchard, E.B.Hickling, E.J.Freidenberg, B.M.Malta, L.S.Kuhn, E.Sykes, M.A.Two studies of psychiatric morbidity among motor vehicle accident survivors 1 year after the crash Behav Res Ther. 42 5 2004 569583CrossRefGoogle ScholarPubMed
Breslau, N.Davis, G.C.Andreski, P.Peterson, E.L.Schultz, L.R.Sex differences in posttraumatic stress disorder Arch Gen Psychiatry. 54 11 1997 10441048CrossRefGoogle ScholarPubMed
Breslau, N.Davis, G.C.Peterson, E.L.Schultz, L.R.A second look at comorbidity in victims of trauma: the posttraumatic stress disorder – Major depression connection Biol Psychiatry. 48 9 2000 902909CrossRefGoogle ScholarPubMed
Brown, E.S.Fulton, M.K.Wilkeson, A.Petty, F.The psychiatric sequelae of civilian trauma Compr Psychiatr. 41 1 2000 1923CrossRefGoogle ScholarPubMed
Dirkzwager, A.J.E.Grievink, L.Van der Velden, P.G.Yzermans, C.J.Risk factors for psychological and physical health problems after a man-made disaster Br J Psychiatry. 2006 189 2006 144149CrossRefGoogle Scholar
Ehlers, A.Mayou, R.A.Bryant, B.Psychological predictors of chronic posttraumatic stress disorder after motor vehicle accidents J Abn Psychol. 107 3 1998 508519CrossRefGoogle ScholarPubMed
Ehring, T.Ehlers, A.Glucksman, E.Contribution of cognitive factors to the prediction of post-traumatic stress disorder, phobia and depression after motor vehicle accidents Behav Res Ther. 44 12 2006 16991716CrossRefGoogle ScholarPubMed
First, M.B.Gibbon, M.Spitzer, R.L.Williams, J.B.W.Benjamin, L.Users guide for structured clinical interview for DSM-IV Axis I disorders (SCID) 1996 Biometrics Research New YorkGoogle Scholar
First, M.B.Spitzer, R.L.Gibbon, M.Williams, J.B.W.Benajmin, L.User's guide for the structured clinical interview for DSM-IV personality disorders(SCID-II) 1996 American Psychiatric Press Washington, DCGoogle Scholar
Freedman, S.A.Brandes, D.Peri, T.Shalev, A.Predictors of chronic post-traumatic stress disorder. A prospective study Br J Psychiatry. 174 1999 353359CrossRefGoogle ScholarPubMed
Fuglsang, A.K.Moergeli, H.Hepp-Beg, S.Schnyder, U.Who develops acute stress disorder after accidental injuries? Psychother Psychosom. 71 4 2002 214222CrossRefGoogle ScholarPubMed
Gabriel, R.Ferrando, L.Cortón, E.S.Mingote, C.García-Camba, E.Liria, A.F.et al.Psychopathological consequences after a terrorist attack: an epidemiological study among victims, the general population, and police officers Eur Psychiatry. 2007 [Epub ahead of print]CrossRefGoogle Scholar
Jehel, L.Paterniti, S.Brunet, A.Duchet, C.Guelfi, J.D.Prediction of the occurrence and intensity of post-traumatic stress disorder in victims 32 months after bomb attack Eur Psychiatry. 18 4 2003 172176CrossRefGoogle ScholarPubMed
Kessing, L.V.Hansen, M.G.Andersen, P.K.Angst, J.The predictive effect of episodes on the risk of recurrence in depressive and bipolar disorders – a life-long perspective Acta Psychiatr Scand. 109 5 2004 339344CrossRefGoogle ScholarPubMed
Koponen, S.Taiminen, T.Kurki, T.Portin, R.Isoniemi, H.Himanen, L.et al.MRI findings and Axis I and II psychiatric disorders after traumatic brain injury: a 30-year retrospective follow-up study Psychiatry Res. 146 3 2006 263270CrossRefGoogle ScholarPubMed
Koren, D.Arnon, I.Klein, E.Acute stress response and posttraumatic stress disorder in traffic accident victims: a one-year prospective follow-up study Am J Psychiatry. 156 3 1999 367373Google ScholarPubMed
Lanius, R.A.Frewen, P.A.Girotti, M.Neufeld, R.W.Stevens, T.K.Densmore, M.Neural correlates of trauma script-imagery in posttraumatic stress disorder with and without comorbid major depression: a functional MRI investigation Psychiatry Res. 155 1 2007 4556CrossRefGoogle ScholarPubMed
Maes, M.Mylle, J.Delmeire, L.Janca, A.Pre- and post-disaster negative life events in relation to the incidence and severity of post-traumatic stress disorder Psychiatry Res. 105 1–2 2001 112CrossRefGoogle ScholarPubMed
Mayou, R.A.Black, J.Bryant, B.Unconsciousness, amnesia and psychiatric symptoms following road traffic accident injury Br J Psychiatry. 177 2000 540545CrossRefGoogle ScholarPubMed
Mayou, R.Ehlers, A.Bryant, B.Posttraumatic stress disorder after motor vehicle accidents: 3-year follow-up of a prospective longitudinal study Behav Res Ther. 40 6 2002 665675CrossRefGoogle ScholarPubMed
Mirza, K.A.Bhadrinath, B.R.Goodyer, I.M.Post-traumatic stress disorder in children and adolescents following road traffic accidents Br J Psychiatry. 172 1998 443447CrossRefGoogle ScholarPubMed
Neria, Y.Bromet, E.J.Editorial: comorbidity of PTSD and depression: linked or separate incidence Biol Psychiatry. 48 9 2000 878880CrossRefGoogle ScholarPubMed
Norris, F.H.Friedman, M.J.Watson, P.J.Byrne, C.M.Diaz, E.Kaniasty, K.et al.an empirical review of the empirical literature, 1981–2001 Psychiatry. 65 2002 207239CrossRefGoogle ScholarPubMed
O'Donnell, M.Creamer, M.Bryant, R.A.Schnyder, U.Shalev, A.Posttraumatic disorders following injury: an empirical and methodological review Clin Psychol Rev. 23 4 2003 587603CrossRefGoogle ScholarPubMed
O'Donnell, M.Creamer, M.Pattison, P.Posttraumatic stress disorder and depression following trauma: understanding comorbidity Am J Psychiatry. 161 8 2004 13901396CrossRefGoogle ScholarPubMed
Schnyder, U.Moergeli, H.Klaghofer, R.Incidence and prediction of posttraumatic stress disorder symptoms in severely injured accident victims Am J Psychiatry. 158 4 2001 594599CrossRefGoogle ScholarPubMed
Sumpter, R.E.McMillan, T.M.Misdiagnosis of post-traumatic stress disorder following severe traumatic brain injury Br J Psychiatry. 186 2005 423426CrossRefGoogle ScholarPubMed
Sundquist, K.Johansson, K.M.DeMarinis, V.Johansson, S.E.Sundquist, J.Posttraumatic stress disorder and psychiatric co-morbidity: symptoms in a random sample of female Bosnian refugees Eur Psychiatry. 20 2 2005 158164CrossRefGoogle Scholar
Szabo, C.P.Coryell, W.H.Illness prediction in psychiatry Acta Psychiatr Scand. 109 5 2004 323324CrossRefGoogle Scholar
Tinkoff, G.H.O'Connor, R.E.Validation of new trauma triage rules for trauma attending response to the emergency department J Trauma. 52 6 2002 11531159CrossRefGoogle ScholarPubMed
Submit a response

Comments

No Comments have been published for this article.