POSTTRAUMATIC-STRESS-DISORDER SYMPTOMS AND THE CLAPHAM RAIL ACCIDENT

Background Post-traumatic stress disorder is a well recognised conditi on which can have long-term consequences. A rail accident to commuter trains in south London provided an opportunity, within the context of a Psychological Therapies Service, to study the prevalence and associa tions of the condition in a follow-up study. Method Postal questionnai res were completed by 187 survivors (52% response rate) 10 to 22 month s after the accident, and their symptoms were compared with a commuter control group. Results The accident group scored significantly higher on the Impact of Events scale (IES) than the control group. Severity of physical injury was significantly associated with high IES scores. Thirty per cent of those moderately or severely injured showed high le vels of intrusion or avoidance symptoms (sub-scores of 20 or more). Th irty per cent of those nearest the accident focus had high sub-scores, associated variables being the accident experience of risk of death, feeling trapped and seeing death. For those less directly involved the proportions with symptoms were similar to those of controls. Conclusi ons It is recommended that disaster services should provide for long-t erm psychological effects, particularly for those survivors who are in jured, who experience risk of death, feeling trapped or who witness de ath.