This report examines initial distress levels, course of symptoms, incidence
of posttraumatic stress disorder (PTSD), predictors of short-term outcome,
and value of prophylactic counseling in a consecutive series of 40 ambulan
t trauma clinic attenders with minor road traffic accident (RTA) injuries.
Subjects were randomly allocated to intervention and monitoring groups foll
owing assessment at a mean of 7 days posttrauma and reassessed at 3 months
using a variety of standard rating scales. Seventy-five percent reported si
gnificant levels of distress at 1 week posttrauma. By 3 months this had dec
reased sharply to 35%, and 22% were significantly impaired by clinical asse
ssment. Incidence of PTSD over 3 months was estimated at 19% and point prev
alence at 3 months posttrauma was 9%. High initial distress, increasing age
, and high levels of perceived threat were significant independent predicto
rs of morbidity, and no significant differences in outcome were found betwe
en intervention and monitoring groups at 3 months. (C) 1998 Elsevier Scienc
e Inc.