Journal of Depression and Anxiety
Open Access

Abstract

Posttraumatic Stress Disorder Following Injury: Trajectories and Impact on Health-Related Quality of Life

Juanita A Haagsma, Ed F van Beeck, Hidde Toet and Suzanne Polinder

Background:Little is known about post traumatic stress disorder (PTSD) trajectories of injury patients of all severity levels and external causes. The aim of our study was to assess prevalence rates, predictors, trajectories and impact on health-related quality of life (HRQoL) of PTSD 2.5, 5, 12 and 24 months post-injury.
Methods:We selected a sample of 8,057 patients aged 15 years and older who attended the Emergency
Department (ED) followed by either hospital admission or discharge to the home environment. The sample received postal questionnaires 2.5, 5, 12 and 24 months after treatment at the ED. The  questionnaires included items regarding socio-demographics, EQ-5D to measure HRQoL, and the Impact of Event Scale-Revised (IESR). An IESR-score ≥ 33 was used as indication for the presence of PTSD.
Results: 2,918 (36%) injury patients completed the 2.5 months follow-up survey. PTSD prevalence rate at 2.5 month follow-up was 9%. At 5, 12 and 24 month follow-up PTSD prevalence rates were 7%, 6% and 5% respectively. Comorbid disease, female gender and low educational level were the strongest independent predictors of PTSD. One in ten patients had PTSD at some point during 24 month follow-up. PTSD was associated with a significantly decreased HRQoL.
Conclusions:We conclude that almost one in ten injury patients of all causes and severity levels treated at an ED suffer from PTSD symptoms, which is associated with a considerable decrease in HRQoL. PTSD symptoms may therefore raise a major barrier for full recovery of injury patients of even minor levels of severity.