PREDICTORS OF POST-TRAUMATIC STRESS DISORDER FOLLOWING MAJOR TRAUMA

Authors

  • Ian A. Harris,

    Corresponding author
    1. * Orthopaedic Department and Centre for Research, Evidence Management and Surveillance, Liverpool Hospital, and Surgical Outcome Research Centre, Sydney, New South Wales, Australia
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  • Jane M. Young,

    1. * Orthopaedic Department and Centre for Research, Evidence Management and Surveillance, Liverpool Hospital, and Surgical Outcome Research Centre, Sydney, New South Wales, Australia
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  • Hamish Rae,

    1. * Orthopaedic Department and Centre for Research, Evidence Management and Surveillance, Liverpool Hospital, and Surgical Outcome Research Centre, Sydney, New South Wales, Australia
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  • Bin B. Jalaludin,

    1. * Orthopaedic Department and Centre for Research, Evidence Management and Surveillance, Liverpool Hospital, and Surgical Outcome Research Centre, Sydney, New South Wales, Australia
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  • Michael J. Solomon

    1. * Orthopaedic Department and Centre for Research, Evidence Management and Surveillance, Liverpool Hospital, and Surgical Outcome Research Centre, Sydney, New South Wales, Australia
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  • I. A. Harris FRACS, PhD; J. M. Young FAFPHM, PhD; H. Rae MB BS, BSc; B. B. Jalaludin FAFPHM, PhD; M. J. Solomon MBChB, FRACS.

Professor Ian A. Harris, PO Box 906, Caringbah, NSW 2229, Australia.
Email: ian.harris@sswahs.nsw.gov.au

Abstract

Background:  Post-traumatic stress disorder (PTSD) is a common sequel to physical trauma, but there is disagreement regarding the predictors of this condition. This study aims to examine the role of physical, psychosocial and compensation-related factors in the development of PTSD following major trauma.

Methods:  Participants were consecutive adult patients presenting to one major trauma centre with major trauma (Injury Severity Score 16 or higher). Baseline characteristics and clinical data were obtained from the hospital trauma database. The presence of PTSD (as measured by the PTSD Checklist, civilian version) and additional data were obtained from a questionnaire mailed to patients between 1 and 6 years after the injury. Multiple linear regression was used to identify significant independent associations with PTSD.

Results:  Among 355 patients (61.0% response fraction), 129 (36.3%, 95% confidence interval 43.2–53.2%) were classed as having PTSD. Symptoms of PTSD were not significantly related to measures of injury severity, the time since the injury, education level, household income or employment status at the time of injury. PTSD was significantly associated with younger age (P < 0.0001), the presence of chronic illnesses (P < 0.0001), unemployment at the time of follow up (P < 0.0001), use of a lawyer (P < 0.0001), blaming others for the injury (P = 0.003) and having an unsettled compensation claim (P = 0.007).

Conclusion:  Post-traumatic stress disorder after major trauma was not related to measures of injury severity, but was related to other factors, such as blaming others for the accident and the processes involved in claiming compensation.

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