Skip to main content
×
Home
    • Aa
    • Aa
  • Get access
    Check if you have access via personal or institutional login
  • Cited by 72
  • Cited by
    This article has been cited by the following publications. This list is generated based on data provided by CrossRef.

    Birur, Badari Moore, Norman C. and Davis, Lori L. 2016. An Evidence-Based Review of Early Intervention and Prevention of Posttraumatic Stress Disorder. Community Mental Health Journal,


    Gouweloos, Juul Postma, Ingri L.E. te Brake, Hans Sijbrandij, Marit Kleber, Rolf J. and Goslings, J. Carel 2016. The risk of PTSD and depression after an airplane crash and its potential association with physical injury: A longitudinal study. Injury, Vol. 47, Issue. 1, p. 250.


    Maheux, Annie and Price, Matthew 2016. The indirect effect of social support on post-trauma psychopathology via self-compassion. Personality and Individual Differences, Vol. 88, p. 102.


    Price, Matthew Sawyer, Tyler Harris, Madison and Skalka, Christian 2016. Usability Evaluation of a Mobile Monitoring System to Assess Symptoms After a Traumatic Injury: A Mixed-Methods Study. JMIR Mental Health, Vol. 3, Issue. 1, p. e3.


    Short, Roland and Almeida, Ryan 2016. Management of Analgesia Through Multiple Phases of Trauma. Current Anesthesiology Reports, Vol. 6, Issue. 1, p. 6.


    Archer, Kristin R Coronado, Rogelio A Haislip, Lori R Abraham, Christine M Vanston, Susan W Lazaro, Anthony E Jackson, James C Ely, E Wesley Guillamondegui, Oscar D and Obremskey, William T 2015. Telephone-based goal management training for adults with mild traumatic brain injury: study protocol for a randomized controlled trial. Trials, Vol. 16, Issue. 1,


    Brennstuhl, Marie-Jo Tarquinio, Cyril and Montel, Sebastien 2015. Chronic Pain and PTSD: Evolving Views on Their Comorbidity. Perspectives in Psychiatric Care, Vol. 51, Issue. 4, p. 295.


    Bryant, R. A. Nickerson, A. Creamer, M. O'Donnell, M. Forbes, D. Galatzer-Levy, I. McFarlane, A. C. and Silove, D. 2015. Trajectory of post-traumatic stress following traumatic injury: 6-year follow-up. The British Journal of Psychiatry, Vol. 206, Issue. 5, p. 417.


    Delahanty, Douglas L. Marley, Robert Fenton, Andrew Salvator, Ann Woofter, Christina Erck, Daniel Coleman, Jennifer and Muakkassa, Farid 2015. A comparison between survival from cancer before and after a physical traumatic injury: physical trauma before cancer is associated with decreased survival. Journal of Trauma Management & Outcomes, Vol. 9, Issue. 1,


    GUINA, JEFFREY ROSSETTER, SARAH R. DeRHODES, BETHANY J. NAHHAS, RAMZI W. and WELTON, RANDON S. 2015. Benzodiazepines for PTSD. Journal of Psychiatric Practice, Vol. 21, Issue. 4, p. 281.


    Zatzick, Douglas O'Connor, Stephen S. Russo, Joan Wang, Jin Bush, Nigel Love, Jeff Peterson, Roselyn Ingraham, Leah Darnell, Doyanne Whiteside, Lauren and Van Eaton, Erik 2015. Technology-Enhanced Stepped Collaborative Care Targeting Posttraumatic Stress Disorder and Comorbidity After Injury: A Randomized Controlled Trial. Journal of Traumatic Stress, Vol. 28, Issue. 5, p. 391.


    Zatzick, Douglas F. Russo, Joan Darnell, Doyanne Chambers, David A. Palinkas, Lawrence Van Eaton, Erik Wang, Jin Ingraham, Leah M. Guiney, Roxanne Heagerty, Patrick Comstock, Bryan Whiteside, Lauren K. and Jurkovich, Gregory 2015. An effectiveness-implementation hybrid trial study protocol targeting posttraumatic stress disorder and comorbidity. Implementation Science, Vol. 11, Issue. 1,


    French, Louis M. Lange, Rael T. Marshall, Kathryn Prokhorenko, Olga Brickell, Tracey A. Bailie, Jason M. Asmussen, Sarah B. Ivins, Brian Cooper, Douglas B. and Kennedy, Jan E. 2014. Influence of the Severity and Location of Bodily Injuries on Post-Concussive and Combat Stress Symptom Reporting after Military-Related Concurrent Mild Traumatic Brain Injuries and Polytrauma. Journal of Neurotrauma, Vol. 31, Issue. 19, p. 1607.


    Hanna, Marie N. Ouanes, Jean-Pierre P. and Tomas, Vicente Garcia 2014. Practical Management of Pain.


    Jayasinghe, Nimali Sparks, Martha A. Kato, Kaori Wyka, Katarzyna Wilbur, Kaitlyn Chiaramonte, Gabrielle Barie, Philip S. Lachs, Mark S. O'Dell, Michael Evans, Arthur Bruce, Martha L. and Difede, JoAnn 2014. Posttraumatic stress symptoms in older adults hospitalized for fall injury. General Hospital Psychiatry, Vol. 36, Issue. 6, p. 669.


    Lubomirsky, Bryan Wang, Xin Xie, Hong Smirnoff, Jennifer B. Biehn, Tracey L. Contractor, Ateka A. Elhai, Jon D. Sutu, Christine Brickman, Kristopher R. Liberzon, Israel McLean, Samuel A. and Tamburrino, Marijo B. 2014. Preliminary Study on the Relationship Between Visitation in the Emergency Department and Posttraumatic Mental Health. Social Work in Mental Health, Vol. 12, Issue. 1, p. 69.


    O'Connor, Stephen S. Dinsio, Kyl Wang, Jin Russo, Joan Rivara, Frederick P. Love, Jeff McFadden, Collin Lapping-Carr, Leiszle Peterson, Roselyn and Zatzick, Douglas F. 2014. Correlates of Suicidal Ideation in Physically Injured Trauma Survivors. Suicide and Life-Threatening Behavior, Vol. 44, Issue. 5, p. 473.


    Osenbach, Janyce E. Lewis, Charles Rosenfeld, Barry Russo, Joan Ingraham, Leah M. Peterson, Roselyn Wang, Jin and Zatzick, Douglas F. 2014. Exploring the Longitudinal Trajectories of Posttraumatic Stress Disorder in Injured Trauma Survivors. Psychiatry: Interpersonal and Biological Processes, Vol. 77, Issue. 4, p. 386.


    Price, Matthew Davidson, Tatiana M. Ruggiero, Kenneth J. Acierno, Ron and Resnick, Heidi S. 2014. Predictors of Using Mental Health Services After Sexual Assault. Journal of Traumatic Stress, Vol. 27, Issue. 3, p. 331.


    Price, Matthew Ruggiero, Kenneth J. Ferguson, Pamela L. Patel, Sachin K. Treiber, Frank Couillard, Deborah and Fahkry, Samir M. 2014. A feasibility pilot study on the use of text messages to track PTSD symptoms after a traumatic injury. General Hospital Psychiatry, Vol. 36, Issue. 3, p. 249.


    ×

A nationwide US study of post-traumatic stress after hospitalization for physical injury

  • DOUGLAS F. ZATZICK (a1) (a2), FREDERICK P. RIVARA (a1), AVERY B. NATHENS (a3), GREGORY J. JURKOVICH (a1), JIN WANG (a1), MING-YU FAN (a2), JOAN RUSSO (a2), DAVID S. SALKEVER (a4) and ELLEN J. MACKENZIE (a4)
  • DOI: http://dx.doi.org/10.1017/S0033291707000943
  • Published online: 01 June 2007
Abstract
ABSTRACTBackground

Injured survivors of individual and mass trauma are at risk for developing post-traumatic stress disorder (PTSD). Few investigations have assessed PTSD after injury in large samples across diverse acute care hospital settings.

Method

A total of 2931 injured trauma survivors aged 18–84 who were representative of 9983 in-patients were recruited from 69 hospitals across the USA. In-patient medical records were abstracted, and hospitalized patients were interviewed at 3 and 12 months after injury. Symptoms consistent with a DSM-IV diagnosis of PTSD were assessed with the PTSD Checklist (PCL) 12 months after injury.

Results

Approximately 23% of injury survivors had symptoms consistent with a diagnosis of PTSD 12 months after their hospitalization. Greater levels of early post-injury emotional distress and physical pain were associated with an increased risk of symptoms consistent with a PTSD diagnosis. Pre-injury, intensive care unit (ICU) admission [relative risk (RR) 1·17, 95% confidence interval (CI) 1·02–1·34], pre-injury depression (RR 1·33, 95% CI 1·15–1·54), benzodiazepine prescription (RR 1·46, 95% CI 1·17–1·84) and intentional injury (RR 1·32, 95% CI 1·04–1·67) were independently associated with an increased risk of symptoms consistent with a PTSD diagnosis. White injury survivors without insurance demonstrated approximately twice the rate of symptoms consistent with a diagnosis of PTSD when compared to white individuals with private insurance. By contrast, for Hispanic injury survivors PTSD rates were approximately equal between uninsured and privately insured individuals.

Conclusions

Nationwide in the USA, more than 20% of injured trauma survivors have symptoms consistent with a diagnosis of PTSD 12 months after acute care in-patient hospitalization. Coordinated investigative and policy efforts could target mandates for high-quality PTSD screening and intervention in acute care medical settings.

Copyright
Corresponding author
*Address for correspondence: Douglas Zatzick, M.D., Associate Professor, Department of Psychiatry and Behavioral Sciences, Harborview Injury Prevention and Research Center, University of Washington, School of Medicine, Box 359896, 325 Ninth Ave, Seattle, WA 98104, USA. (Email: dzatzick@u.washington.edu)
Linked references
Hide All

This list contains references from the content that can be linked to their source. For a full set of references and notes please see the PDF or HTML where available.

J. D. Birkmeyer , T. A. Stukel , A. E. Siewers , P. P. Goodney , D. E. Wennberg & F. L. Lucas (2003). Surgeon volume and operative mortality in the United States. New England Journal of Medicine 349, 21172127.

E. B. Blanchard , E. J. Hickling , A. E. Taylor & W. Loos (1995). Psychiatric morbidity associated with motor vehicle accidents. Journal of Nervous and Mental Disease 183, 495504.

E. B. Blanchard , J. Jones-Alexander , T. C. Buckley & C. A. Forneris (1996). Psychometric properties of the PTSD Checklist. Behaviour Research and Therapy 34, 669673.

J. Breslau , S. Aguilar-Gaxiola , G. Borges , R. C. Castilla-Puentes , K. S. Kendler , M. E. Medina-Mora , M. Su & R. C. Kessler (2007). Mental disorders among English-speaking Mexican immigrants to the US compared to a national sample of Mexicans. Psychiatry Research 151, 115122.

C. R. Brewin , B. Andrews & J. D. Valentine (2000). Meta-analysis of risk factors for posttraumatic stress disorder in trauma-exposed adults. Journal of Consulting and Clinical Psychology 68, 748766.

R. A. Bryant , A. G. Harvey , R. M. Guthrie & M. L. Moulds (2000). A prospective study of psychophysiological arousal, acute stress disorder, and posttraumatic stress disorder. Journal of Abnormal Psychology 109, 341344.

H. D. Chilcoat & N. Breslau (1998). Investigations of causal pathways between PTSD and drug use disorders. Addictive Behaviors 23, 827840.

B. H. Cuthbertson , A. Hull , M. Strachan & J. Scott (2004). Post-traumatic stress disorder after critical illness requiring general intensive care. Intensive Care Medicine 30, 450455.

R. B. D'Agostino Jr. & R. B. D'Agostino Sr. (2007). Estimating treatment effects using observational data. Journal of the American Medical Association 297, 314316.

B. S. Dansky , M. E. Saladin , K. T. Brady , D. G. Kilpatrick & H. S. Resnick (1995). Prevalence of victimization and posttraumatic stress disorder among women with substance abuse disorders: comparison of telephone and in-person assessment samples. International Journal of Addictions 30, 10791099.

A. Ehlers , R. A. Mayou & B. Bryant (1998). Psychological predictors of chronic posttraumatic stress disorder after motor vehicle accidents. Journal of Abnormal Psychology 107, 508519.

S. Galea , D. Vlahov , M. Tracy , D. R. Hoover , H. Resnick & D. Kilpatrick (2004). Hispanic ethnicity and post-traumatic stress disorder after a disaster: evidence from a general population survey after September 11, 2001. Annals of Epidemiology 14, 520531.

T. A. Grieger , S. J. Cozza , R. J. Ursano , C. Hoge , P. E. Martinez , C. C. Engel & H. J. Wain (2006). Posttraumatic stress disorder and depression in battle-injured soldiers. American Journal of Psychiatry 163, 17771783.

C. W. Hoge , C. A. Castro , S. C. Messer , D. McGurk , D. I. Cotting & R. L. Koffman (2004). Combat duty in Iraq and Afghanistan, mental health problems, and barriers to care. New England Journal of Medicine 351, 1322.

T. L. Holbrook , J. P. Anderson , W. J. Sieber , D. Browner & D. B. Hoyt (1999). Outcome after major trauma: 12-month and 18-month follow-up results from the trauma recovery project. Journal of Trauma 46, 765773.

T. L. Holbrook , D. B. Hoyt , M. B. Stein & W. J. Sieber (2001). Perceived threat to life predicts posttraumatic stress disorder after major trauma: risk factors and functional outcome. Journal of Trauma 51, 287293.

H. P. Kapfhammer , H. B. Rothenhausler , T. Krauseneck , C. Stoll & G. Schelling (2004). Posttraumatic stress disorder and health-related quality of life in long-term survivors of acute respiratory distress syndrome. American Journal of Psychiatry 161, 4552.

W. Katon , M. Von Korff , E. Lin , E. Walker , G. E. Simon , T. B. Bush , P. Robinson & J. Russo (1995). Collaborative management to achieve treatment guidelines: impact on depression in primary care. Journal of the American Medical Association 273, 10261031.

W. Katon , D. Zatzick , G. Bond & J. Williams Jr. (2006). Dissemination of evidence-based mental health interventions: importance to the trauma field. Journal of Traumatic Stress 19, 611623.

R. C. Kessler , A. Sonnega , E. Bromet , M. Hughs & C. B. Nelson (1995). Posttraumatic stress disorder in the National Comorbidity Survey. Archives of General Psychiatry 52, 10481060.

E. J. MacKenzie , F. P. Rivara , G. J. Jurkovich , A. B. Nathens , K. P. Frey , B. L. Egleston , D. S. Salkever & D. O. Scharfstein (2006). A national evaluation of the effect of trauma-center care on mortality. New England Journal of Medicine 354, 366378.

M. Maes , L. Delmeire , J. Mylle & C. Altamura (2001). Risk and preventive factors of post-traumatic stress disorder (PTSD): alcohol consumption and intoxication prior to a traumatic event diminishes the relative risk to develop PTSD in response to that trauma. Journal of Affective Disorders 63, 113121.

G. N. Marshall & M. Orlando (2002). Acculturation and peritraumatic dissociation in young adult Latino survivors of community violence. Journal of Abnormal Psychology 111, 166174.

G. N. Marshall & T. L. Schell (2002). Reappraising the link between peritraumatic dissociation and PTSD symptom severity: evidence from a longitudinal study of community violence survivors. Journal of Abnormal Psychology 111, 626636.

R. Mayou , B. Bryant & R. Duthie (1993). Psychiatric consequences of road traffic accidents. British Medical Journal 307, 647651.

R. Mayou , S. Tyndel & B. Bryant (1997). Long-term outcome of motor vehicle accident injury. Psychosomatic Medicine 59, 578584.

T. A. Mellman , D. David , V. Bustamante , A. I. Fins & K. Esposito (2001). Predictors of post-traumatic stress disorder following severe injury. Depression and Anxiety 14, 226231.

T. A. Mellman , J. Ramos , D. David , L. Williams & J. S. Augenstein (1998). Possible inhibition of early PTSD symptoms by alcohol intoxication. Depression and Anxiety 7, 145.

A. J. Michaels , C. E. Michaels , M. A. Zimmerman , J. S. Smith , C. H. Moon & C. Peterson (1999). Posttraumatic stress disorder in injured adults: etiology by path analysis. Journal of Trauma 47, 867873.

A. B. Nathens , G. J. Jurkovich , P. Cummings , F. P. Rivara & R. V. Maier (2000). The effect of organized systems of trauma care on motor vehicle crash mortality. Journal of the American Medical Association 283, 19901994.

M. L. O'Donnell , M. Creamer , R. A. Bryant , U. Schnyder & A. Y. Shalev (2003). Posttraumatic disorders following injury: an empirical and methodological review. Clinical Psychology Review 23, 587603.

M. L. O'Donnell , M. Creamer , P. Elliott , C. Atkin & T. Kossmann (2005). Determinants of quality of life and role-related disability after injury: impact of acute psychological responses. Journal of Trauma 59, 13281335.

M. L. O'Donnell , M. Creamer & P. Pattison (2004). Posttraumatic stress disorder and depression following trauma: understanding comorbidity. American Journal of Psychiatry 161, 13901396.

E. J. Ozer , S. R. Best , T. L. Lipsey & D. S. Weiss (2003). Predictors of posttraumatic stress disorder and symptoms in adults: a meta-analysis. Psychological Bulletin 129, 5273.

N. Pole , S. R. Best , T. Metzler & C. R. Marmar (2005). Why are hispanics at greater risk for PTSD? Cultural Diversity and Ethnic Minority Psychology 11, 144161.

P. P. Roy-Byrne , M. G. Craske , M. B. Stein , G. Sullivan , A. Bystritsky , W. Katon , D. Golinelli & C. D. Sherbourne (2005). A randomized effectiveness trial of cognitive-behavioral therapy and medication for primary care panic disorder. Archives of General Psychiatry 62, 290298.

D. Rubin (1987). Multiple Imputation for Nonresponse in Surveys. Wiley: New York.

A. M. Ruef , B. T. Litz & W. E. Schlenger (2000). Hispanic ethnicity and risk for combat-related posttraumatic stress disorder. Cultural Diversity and Ethnic Minority Psychology 6, 235251.

G. Saxe , F. Stoddard , D. Courtney , K. Cunningham , N. Chawla , R. Sheridan , D. King & L. King (2001). Relationship between acute morphine and the course of PTSD in children with burns. Journal of the American Academy of Child and Adolescent Psychiatry 40, 915921.

G. Schelling , E. Kilger , B. Roozendaal , D. J. de Quervain , J. Briegel , A. Dagge , H. B. Rothenhausler , T. Krauseneck , G. Nollert & H. P. Kapfhammer (2004). Stress doses of hydrocortisone, traumatic memories, and symptoms of posttraumatic stress disorder in patients after cardiac surgery: a randomized study. Biological Psychiatry 55, 627633.

U. Schnyder , H. Moergeli , R. Klaghofer & C. Buddeberg (2001). Incidence and prediction of posttraumatic stress disorder symptoms in severely injured accident victims. American Journal of Psychiatry 158, 594599.

A. Y. Shalev , S. Freedman , T. Peri , D. Brandes , T. Sahar , S. P. Orr & R. K. Pitman (1998). Prospective study of posttraumatic stress disorder and depression following trauma. American Journal of Psychiatry 155, 630637.

R. J. Shaw , T. E. Robinson & H. Steiner (2002). Acute stress disorder following ventilation. Psychosomatics 43, 7476.

G. E. Simon , M. Von Korff , M. Piccinelli , C. S. Fullerton & J. Ormel (1999). An international study of the relation between somatic symptoms and depression. New England Journal of Medicine 341, 13291335.

J. Unutzer , W. Katon , C. M. Callahan , J. W. Williams Jr., E. Hunkeler , L. Harpole , M. Hoffing , R. D. Della Penna , P. H. Noel , E. H. Lin , P. A. Arean , M. T. Hegel , L. Tang , T. R. Belin , S. Oishi & C. Langston (2002). Collaborative care management of late-life depression in the primary care setting: a randomized controlled trial. Journal of the American Medical Association 288, 28362845.

P. Verger , W. Dab , D. L. Lamping , J. Y. Loze , C. Deschaseaux-Voinet , L. Abenhaim & F. Rouillon (2004). The psychological impact of terrorism: an epidemiologic study of posttraumatic stress disorder and associated factors in victims of the 1995–1996 bombings in France. American Journal of Psychiatry 161, 13841389.

P. S. Wang , M. Lane , M. Olfson , H. A. Pincus , K. B. Wells & R. C. Kessler (2005). Twelve-month use of mental health services in the United States: results from the National Comorbidity Survey Replication. Archives of General Psychiatry 62, 629640.

K. B. Wells , C. Sherbourne , M. Schoenbaum , N. Duan , L. Meredith , J. Unutzer , J. Miranda , M. F. Carney & L. V. Rubenstein (2000). Impact of disseminating quality improvement programs for depression in managed primary care: a randomized controlled trial. Journal of the American Medical Association 283, 212220.

D. Zatzick , G. J. Jurkovich , L. M. Gentilello , D. H. Wisner & F. P. Rivara (2002 a). Posttraumatic stress, problem drinking and functioning 1 year after injury. Archives of Surgery 137, 200205.

D. Zatzick , S. M. Kang , H. G. Muller , J. E. Russo , F. P. Rivara , W. Katon , G. J. Jurkovich & P. Roy-Byrne (2002 b). Predicting posttraumatic distress in hospitalized trauma survivors with acute injuries. American Journal of Psychiatry 159, 941946.

D. Zatzick & P. Roy-Byrne (2006). From bedside to bench: how the epidemiology of clinical practice can inform the secondary prevention of PTSD. Psychiatric Services 57, 17261730.

D. Zatzick , P. Roy-Byrne , J. Russo , F. Rivara , R. Droesch , A. Wagner , C. Dunn , G. Jurkovich , E. Uehara & W. Katon (2004). A randomized effectiveness trial of stepped collaborative care for acutely injured trauma survivors. Archives of General Psychiatry 61, 498506.

G. Zou (2004). A modified Poisson regression approach to prospective studies with binary data. American Journal of Epidemiology 159, 702706.

Recommend this journal

Email your librarian or administrator to recommend adding this journal to your organisation's collection.

Psychological Medicine
  • ISSN: 0033-2917
  • EISSN: 1469-8978
  • URL: /core/journals/psychological-medicine
Please enter your name
Please enter a valid email address
Who would you like to send this to? *
×