Acure stress disorder an post-tramatic stressdisorder among patients severely injured in motor vehicle accidents in Japan

Department of Psychiatry, Juntendo University, Edo, Tōkyō, Japan
General Hospital Psychiatry (Impact Factor: 2.61). 05/2006; 28(3):234-41. DOI: 10.1016/j.genhosppsych.2006.02.007
Source: PubMed


The prevalence of acute stress disorder (ASD) and posttraumatic stress disorder (PTSD) in seriously injured survivors of motor vehicle accidents (MVAs) in Japan was investigated. Furthermore, predictive factors in the early stage for development of PTSD were evaluated.
Subjects were consecutive samples (N=100) of patients hospitalized with severe MVA injuries surveyed at two time points: within 1 month after the MVA and then 6 months later. In the first survey, we conducted the Acute Stress Disorder Interview and compiled results of a self-rating questionnaire; in the second survey, we conducted a structured clinical interview via telephone.
The prevalence of ASD and PTSD were 9.0% and 8.5%, respectively. The shift from ASD to PTSD was more pronounced when we included partial diagnoses of ASD and PTSD. Three predictive factors for PTSD were identified through multiple logistic analysis: ASD-positive, presence of persistent physical disability and physical injury severity.
Even among severely injured MVA survivors, most acute stress symptoms subside over time. However, having ASD or partial ASD in the early stage, and the presence of physical disability as an aftereffect are strong predictive factors for PTSD. These findings validate the importance of evidence-based intervention for ASD to forestall PTSD.

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    • "(3 and 6 months), Holeva [52] (4–6 months), Bryant [57] (6 months), Hamanaka [54] (6 months), Fuglsang [66] (6–8 months), Bryant [70] (2 years) "
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    • "Recent studies with strict methodology have shown that accident-related PTSD is fairly common (Figure 1). The prevalence of PTSD determined by structured clinical interviews with injured patients consecutively admitted to the ICU or emergency department ranges from 5-30% at 0-3 months after accidental injury [7,9,10,12,22-24] to 2-23% at 4-12 months after [7,9-11,22-25]. Recent large epidemiological studies have reported a 17-23% point prevalence of questionnaire-estimated clinically significant PTSD symptoms at 4-12 months after accidental injury [5,6]. "
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    Full-text · Article · Feb 2011 · BioPsychoSocial Medicine
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    • "Richmond and Jacoby (2008) debunk the notion that eliciting information regarding the traumatizing, injurycausing event will exacerbate the injured person's distress and recommend that a psychological interview be conducted , with the interviewing focusing on information considered relevant to the injury event and to medical management. Research findings suggest that healthcare providers' efforts to evaluate, normalize, and intervene around peri-injury emotional distress reactions may serve to offset the development of posttraumatic stress disorder (Hamanaka et al. 2006), and by offsetting the development of PTSD, reduce healthcare utilization (Duckworth and Iezzi 2005). "
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