Date of this Version
General Hospital Psychiatry
OBJECTIVE: The objective was to develop a predictive screener that when given soon after injury will accurately differentiate those who will later develop depression or posttraumatic stress disorder (PTSD) from those who will not.
METHOD: This study used a prospective, longitudinal cohort design. Subjects were randomly selected from all injured patients in the emergency department; the majority was assessed within 1 week postinjury with a short predictive screener, followed with in-person interviews after 3 and 6 months to determine the emergence of depression or PTSD within 6 months after injury.
RESULTS: A total of 192 completed a risk factor survey at baseline; 165 were assessed over 6 months. Twenty-six subjects [15.8%, 95% confidence interval (CI) 10.2-21.3] were diagnosed with depression, four (2.4%, 95% CI 0.7-5.9) with PTSD and one with both. The final eight-item predictive screener was derived; optimal cutoff scores were ≥2 (of 4) depression risk items and ≥3 (of 5) PTSD risk items. The final screener demonstrated excellent sensitivity and moderate specificity both for clinically significant symptoms and for the diagnoses of depression and PTSD.
CONCLUSIONS: A simple screener that can help identify those patients at highest risk for future development of PTSD and depression postinjury allows the judicious allocation of costly mental health resources.
© 2011. This manuscript version is made available under the CC-BY-NC-ND 4.0 license http://creativecommons.org/licenses/by-nc-nd/4.0/
Adult, Cohort Studies, Depression, Female, Forecasting, Health Surveys, Humans, Male, Middle Aged, Prospective Studies, Risk Assessment, Stress Disorders, Post-Traumatic, United States, Wounds and Injuries, Young Adult
Richmond, T. S., Ruzek, J., Ackerson, T., Wiebe, D., Winston, F., & Kassam-Adams, N. (2011). Predicting the Future Development of Depression or PTSD After Injury. General Hospital Psychiatry, 33 (4), 327-335. http://dx.doi.org/10.1016/j.genhosppsych.2011.05.003
Date Posted: 08 July 2016
This document has been peer reviewed.