Prediction of posttraumatic stress disorder by immediate reactions to trauma: A prospective study in road traffic accident victims

Road traffic accidents often cause serious physical and psychological seque lae. Specialists of various medical faculties are involved in the treatment of accident victims. Little is known about the factors which might predict psychiatric disorders, e.g. Posttraumatic Stress Disorder (PTSD) after acc idents and how psychological problems influence physical treatment. In a pr ospective study 179 unselected, consecutively admitted road traffic acciden t victims were assessed a few days after the accident for psychiatric diagn oses, severity of injury and psychopathology. All were inpatients and had t o be treated for bone fractures. At B-months follow-up assessment 152 (85%) of the patients were interviewed again. Of the patients, 18.4% fulfilled t he criteria for Posttraumatic Stress Disorder (DSM-III-R) within 6 months a fter the accident. Patients who developed PTSD were injured more severely a nd showed more symptoms of anxiety, depression and PTSD a few days after th e accident than patients with no psychiatric diagnosis. Patients with PTSD stayed significantly longer in the hospital than the other patients. Multip le regression analysis revealed that the length of hospitalization was due mainly to a diversity of factors such as severity of injury, severity of ac cident, premorbid personality and psychopathology. Posttraumatic stress dis order is common after road traffic accidents. Patients with PTSD at follow- up can be identified by findings from early assessment. Untreated psycholog ical sequelae such as PTSD cause longer hospitalization and therefore more costs than in non-PTSD patients.