Psychiatric disorders after an accident: predictors and the influence of the psychiatric condition prior to an accident.

Wrenger M, Lange C, Langer M, Heuft G, Burgmer M

Abstract

BACKGROUND: The goal of this study is to assess prevalence and incidence of psychiatric sequelae in a sample of inpatient accident survivors. Such an attempt to assess psychiatric conditions that originate due to an accident seems to be important; this does not include psychiatric conditions already present prior to the accident. METHOD: 208 accident victims were consecutively examined over a period of 12months using DSM-IV diagnostic assessment, CAPS, and self-evaluating questionnaires as well as ISS for injury severity. A predictor model for psychiatric disorders was set up. RESULTS: Incidence of newly developed Axis I disorders in our sample was 14.2% (6months) and 12.3% (12months). Incidence of PTSD was 5.9% (6months) and 2.5% (12months). Comorbidity was a general phenomenon. The psychiatric condition prior to the accident could be identified as a predictor for the development of Axis I disorders. The subjectively evaluated intensity of experienced threat to life and female gender were the main predictors for the development of PTSD. CONCLUSIONS: Accidents can lead to different psychiatric disorders. PTSD as a single diagnosis is rare. Without taking into account pre-existing disorders, the incidence may be overestimated. Two predictor models for the development of PTSD and other mental disorders are presented.