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Predictors of chronic post-traumatic stress disorder

A prospective study

Published online by Cambridge University Press:  02 January 2018

Sara A. Freedman
Affiliation:
Center for Traumatic Stress, Hadassah University Hospital, Jerusalem, Israel
Dalia Brandes
Affiliation:
Center for Traumatic Stress, Hadassah University Hospital, Jerusalem, Israel
Tuvia Peri
Affiliation:
Center for Traumatic Stress, Hadassah University Hospital, Jerusalem, Israel
Arieh Y. Shalev*
Affiliation:
Center for Traumatic Stress, Hadassah University Hospital, Jerusalem, Israel
*
Dr A. Shalev, Department of Psychiatry, Hadassah University Hospital, PO Box 12000, Jerusalem, 91120, Israel. Tel: 972-2-677184; Fax: 972-2-6434434; e-mail: ashalev@cc.huji.ac.il

Abstract

Background

Most individuals who, shortly after trauma, express symptoms of post-traumatic stress disorder (PTSD) recover within one year of their traumatic experiences. In contrast, those who remain ill for one year rarely recover completely. The early identification of the latter is, therefore, very important.

Aims

To prospectively evaluate predictors of PTSD at four months and one year.

Method

We followed 236 trauma survivors recruited from admissions to a general hospital's emergency room for four months, at which point 41 (17.4%) met diagnostic criteria for PTSD. Twenty-three of these individuals, and 39 individuals without PTSD at four months, were assessed again at one year.

Results

Depressive symptoms were the best predictors of PTSD at both time points. Intrusive symptoms and peri-traumatic dissociation were better at predicting four-month PTSD than one-year PTSD.

Conclusions

The occurrence of depression during the months that follow a traumatic event is an important mediator of chronicity in PTSD.

Type
Papers
Copyright
Copyright © 1999 The Royal College of Psychiatrists 

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Footnotes

Declaration of interest

Supported by a US Public Health Service research grant MH-50379.

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