Research Reports - Trajectory of post-traumatic stress following traumatic injury

Br J Psychiatry. 2015 Feb 5

Bryant RA(1), Nickerson A(1), Creamer M(1), O'Donnell M(1), Forbes D(1),
Galatzer-Levy I(1), McFarlane AC(1), Silove D(1)

Background Traumatic injuries affect millions of patients each year, and
resulting post-traumatic stress disorder (PTSD) significantly contributes to
subsequent impairment. Aims To map the distinctive long-term trajectories of PTSD
responses over 6 years by using latent growth mixture modelling. Method Randomly
selected injury patients (n = 1084) admitted to four hospitals around Australia
were assessed in hospital, and at 3, 12, 24 and 72 months. Lifetime psychiatric
history and current PTSD severity and functioning were assessed. Results Five
trajectories of PTSD response were noted across the 6 years: (a) chronic (4%),
(b) recovery (6%), (c) worsening/recovery (8%), (d) worsening (10%) and (e)
resilient (73%). A poorer trajectory was predicted by female gender, recent life
stressors, presence of mild traumatic brain injury and admission to intensive
care unit. Conclusions These findings demonstrate the long-term PTSD effects that
can occur following traumatic injury. The different trajectories highlight that
monitoring a subset of patients over time is probably a more accurate means of
identifying PTSD rather than relying on factors that can be assessed during
hospital admission.

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