Predictors of chronic post-traumatic stress disorder - A prospective study

Background Most individuals who, shortly after trauma, express symptoms of post-traumatic stress disorder (PTSD) recover within one year of their trau matic experiences. In contrast, those who remain ill for one year rarely re cover completely. The early identification of the latter is, therefore, ver y important. Aims To prospectively evaluate predictors of PTSD at four months and one ye ar. Method We followed 236 trauma survivors recruited from admissions to a gene ral hospital's emergency room for four months, at which point 41 (17.4%) me t diagnostic criteria for PTSD. Twenty-three of these individuals, and 39 i ndividuals without PTSD at four months, were assessed again atone year. Results Depressive symptoms were the best predictors of PTSD at both time p oints. Intrusive symptoms and peri-traumatic dissociation were better at pr edicting four-month PTSD than one-year PTSD. Conclusions The occurrence of depression during the months that follow a tr aumatic event is an important mediator of chronicity in PTSD. Declaration of interest Supported by a US Public Health Service research gr ant MH-50379.