Prediction of psychiatric morbidity in severely injured accident victims at one-year follow-up

Am J Respir Crit Care Med. 2001 Aug 15;164(4):653-6. doi: 10.1164/ajrccm.164.4.2008087.


The objective of this study was to assess the prevalence of posttraumatic stress disorder (PTSD) and symptoms of depression and anxiety in severely injured accident victims 1 yr posttrauma and to predict psychiatric morbidity by means of variables assessed shortly after the accident. The sample consisted of 106 consecutive patients with accidental injuries (mean Injury Severity Score = 21.9, mean Glasgow Coma Scale score = 14.4) admitted to the intensive care unit of a University Hospital. Patients with severe head injuries, suicide attempters, and victims of physical assault were excluded. At 1-yr follow-up, two patients (1.9%) had PTSD, and 13 (12.3%) had subsyndromal PTSD. Eighteen patients (17%) had clinically relevant symptoms of anxiety, and nine (8.5%) were depressed. Overall, 27 patients (25.5%) showed some form of psychiatric morbidity (full or subsyndromal PTSD and/or anxiety and/or depression). Logistic regression analysis, using 1-yr psychiatric morbidity status as the dependent variable, allowed correct classification of 83.8% of patients 12 mo postaccident (specificity 91.8%, sensitivity 61.5%). Biographical risk factors and a sense of death threat contributed significantly to the predictive model. We conclude that a substantial proportion of severely injured accident victims develop some form of psychiatric morbidity that can be predicted to some degree by mainly psychosocial variables.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adaptation, Psychological
  • Adult
  • Anxiety / diagnosis
  • Anxiety / epidemiology
  • Anxiety / etiology*
  • Attitude to Death
  • Depression / diagnosis
  • Depression / epidemiology
  • Depression / etiology*
  • Female
  • Follow-Up Studies
  • Glasgow Coma Scale
  • Humans
  • Injury Severity Score
  • Internal-External Control
  • Life Change Events
  • Logistic Models
  • Male
  • Middle Aged
  • Morbidity
  • Multiple Trauma / complications*
  • Multiple Trauma / psychology*
  • Predictive Value of Tests
  • Problem Solving
  • Risk Factors
  • Sensitivity and Specificity
  • Sex Distribution
  • Stress Disorders, Post-Traumatic / diagnosis
  • Stress Disorders, Post-Traumatic / epidemiology
  • Stress Disorders, Post-Traumatic / etiology*
  • Surveys and Questionnaires