Incident mental disorders in the aftermath of traumatic events: A prospective-longitudinal community study

Abstract

Background: Few strictly prospective-longitudinal community studies examined the role of traumatic events for risk of developing a broad range of incident mental disorders over several years.

Method: A representative community sample of adolescents and young adults (n = 2797, baseline age 14-24) was prospectively examined in up to three assessment waves over up to 10 years. Traumatic events and DSM-IV mental disorders were assessed at each wave using the DIA-X/M-CIDI. Associations between traumatic events (meeting the DSM-IV A1-criterion for posttraumatic stress disorder, PTSD) or qualifying traumatic events (meeting the DSM-IV A2-criterion) at baseline and incident disorders at follow-up were tested with logistic regressions adjusted for gender and age.

Results: While traumatic and qualifying traumatic events at baseline were related to various baseline disorders, considerably fewer associations were found in strictly prospective analyses with incident disorders at follow-up as outcomes. After adjustment for baseline disorders, only (a) the association of traumatic events with incident specific phobias (Odds Ratio, OR = 1.6) and (b) the associations of qualifying traumatic events with incident specific phobias (OR = 1.6), PTSD (OR = 2.5) and major depressive episodes (OR = 1.4) remained significant.

Conclusion: Targeted prevention and early intervention among traumatized individuals may be particularly beneficial to lower the incidence of specific phobias and MDE besides PTSD.

Limitations: Associations between traumatic events and incident mental disorders might be underestimated, as cases developing psychopathology immediately after trauma exposure prior to baseline were excluded in our strictly prospective analyses.

Keywords: Anxiety; Child and adolescent psychiatry; Depression; Epidemiology; Psychopathology; Trauma.