EARLY PSYCHOLOGICAL REACTIONS IN A GROUP OF INDIVIDUALS WITH PREEXISTING AND ENDURING MENTAL-HEALTH DIFFICULTIES FOLLOWING A MAJOR COACH ACCIDENT

Background. The impact of major trauma on individuals with pre-existin g and enduring mental health difficulties is poorly understood. Method . Twenty individuals with pre-existing and enduring mental health diff iculties were assessed with the Clinician Administered Post Traumatic Stress Disorder Scale, the 28-item version of the GHO, the Hospital An xiety and Depression Scale, and the Impact of Event Scale between four and eight weeks after their involvement in a major coach accident. Re sults. Ten (50%) individuals satisfied the full DSM-IV criteria for a diagnosis of PTSD. The questionnaire scores indicated a high level of psychological suffering among the group. On dividing the sample into t hose individuals with previous diagnoses of anxiety or depressive diso rders and those with a previous diagnosis of chronic schizophrenia, th e schizophrenia group displayed less marked psychological sequelae on all measures. Conclusion. There was a high incidence of early psycholo gical sequelae among the group as a whole. Some diagnoses (e.g. depres sion and anxiety) may predispose to psychological sequelae while other s (e.g. chronic schizophrenia) may not.