Skip to main content

Advertisement

SpringerLink
Log in

Onset and maintenance of psychiatric disorders after serious accidents

  • ORIGINAL PAPER
  • Published:
European Archives of Psychiatry and Clinical Neuroscience Aims and scope Submit manuscript

Abstract

The purpose of this study was to prospectively investigate the onset, course, and remission of psychiatric disorders in the first 6 months after a serious accident for consecutive patients in a hospital emergency department. Participants were 58 patients aged 18–65 who were assessed shortly after attending a hospital emergency department and were followed up 6 months afterwards. Patients were interviewed with regard to past and current psychiatric history using different instruments (e.g. SCID for DSM-IV).

Prior to their accidents, 35% of all subjects had experienced one or more psychiatric disorders (lifetime prevalence). Shortly after the accident, the incidence of Acute Stress Disorder (7%), subsyndromal Acute Stress Disorder (12%), and adjustment disorder (1.5%) was increased as a reaction to the accident. At this time, 29% of all patients suffered from an acute psychiatric disorder. Six-months after the accident, 10% of the subjects met criteria for Major Depression, 6% for PTSD, 4% for subsyndromal PTSD, and 1.5% for Specific Phobia as newly developed disorders. The course of the psychiatric disorders shows that those patients who met criteria for any psychiatric diagnosis shortly after the accident ran a much higher risk for developing new or comorbid psychiatric disorders in the future.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Fig. 1

Similar content being viewed by others

References

  1. Blanchard EB, Hickling EJ, Taylor AE, Loos W (1995) Psychiatric morbidity associated with motor vehicle accidents. J Nerv Ment Dis 183:495–504

    Article  PubMed  CAS  Google Scholar 

  2. Blanchard EB, Hickling EJ, Taylor AE, Loos WR, Gerardi RJ (1994) Psychological morbidity associated with motor vehicle accidents. Behav Res Ther 32:283–290

    Article  PubMed  CAS  Google Scholar 

  3. Blaszczynski A, Gordon K, Silove D, Sloane D, Hillman K, Panasetis P (1998) Psychiatric morbidity following motor vehicle accidents: a review of methodological issues. Compr Psychiatry 39:111–121

    Article  PubMed  CAS  Google Scholar 

  4. Brewin CR, Andrews B, Valentine JD (2000) Meta-analysis of risk factors for posttraumatic stress disorder in trauma-exposed adults. J Consult Clin Psychol 68:748–766

    Article  PubMed  CAS  Google Scholar 

  5. Bryant RA, Harvey AG (1998) Relationship between acute stress disorder and posttraumatic stress disorder following mild traumatic brain injury. Am J Psychiatry 155:625–629

    PubMed  CAS  Google Scholar 

  6. Bryant RA, Harvey AG (2002) Delayed-onset posttraumatic stress disorder: a prospective evaluation. Aust N Z J Psychiatry 36:205–209

    Article  PubMed  Google Scholar 

  7. Bryant RA, Harvey AG (2003) Gender differences in the relationship between acute stress disorder and posttraumatic stress disorder following motor vehicle accidents. Aust N Z J Psychiatry 37:226–229

    Article  PubMed  Google Scholar 

  8. Freedman SA, Brandes D, Peri T, Shalev A (1999) Predictors of chronic post-traumatic stress disorder. A prospective study. Br J Psychiatry 174:353–359

    PubMed  CAS  Google Scholar 

  9. Frommberger UH, Stieglitz RD, Nyberg E, Schlickewei W, Kuner E, Berger M (1998) Prediction of posttraumatic stress disorder by immediate reactions to trauma: a prospective study in road traffic accident victims. Eur Arch Psychiatry Clin Neurosci 248:316–321

    Article  PubMed  CAS  Google Scholar 

  10. Frommberger UH, Schlickewei W, Stieglitz R-D, Nyberg E, Kuner E, Berger M (1998) Die psychischen Folgen nach Verkehrsunfällen. Teil I: Relevanz, diagnostische Kriterien und Therapie psychischer Störungen. Unfallchirurgie 24:115–121

    Article  Google Scholar 

  11. Fuglsang AK, Moergeli H, Hepp-Beg S, Schnyder U (2002) Who develops acute stress disorder after accidental injuries? Psychother Psychosom 71:214–222

    Article  PubMed  Google Scholar 

  12. Greenspan L, McLellan BA, Greig H (1985) Abbreviated injury scale and injury severity score: a scoring chart. J Trauma 25:60–64

    Article  PubMed  CAS  Google Scholar 

  13. Harvey AG, Bryant RA (1999) Predictors of acute stress following motor vehicle accidents. J Trauma Stress 12:519–525

    Article  PubMed  CAS  Google Scholar 

  14. Kessler RC, Sonnega A, Bromet E, Hughes M, Nelson CB (1995) Posttraumatic stress disorder in the national comorbidity survey. Arch Gen Psychiatry 52:1048–1060

    PubMed  CAS  Google Scholar 

  15. Koren D, Arnon I, Klein E (1999) Acute stress response and posttraumatic stress disorder in traffic accident victims: a one-year prospective, follow-up study. Am J Psychiatry 156:367–373

    PubMed  CAS  Google Scholar 

  16. Malt U (1988) The long-term psychiatric consequences of accidental injury. Br J Psychiatry 153:810–818

    Article  PubMed  CAS  Google Scholar 

  17. Malt U, Myhrer T, Blikra G, Hoivik B (1987) Psychopathology and accidental injuries. Acta Psychiatr Scand 76:261–271

    PubMed  CAS  Google Scholar 

  18. Mayou R (1992) Psychiatric aspects of road traffic accidents. Int Rev Psychiatry 4:45–54

    Google Scholar 

  19. Mayou R, Bryant B, Ehlers A (2001) Prediction of psychological outcomes one year after a motor vehicle accident. Am J Psychiatry 158:1231–1238

    Article  PubMed  CAS  Google Scholar 

  20. McFarlane AC, Atchison M, Yehuda R (1997) The acute stress response following motor vehicle accidents and its relation to PTSD. Ann N Y Acad Sci 821:437–441

    PubMed  CAS  Google Scholar 

  21. Mellman TA, David D, Bustamante V, Fins AI, Esposito K (2001) Predictors of post-traumatic stress disorder following severe injury. Depress Anxiety 14:226–231

    Article  PubMed  CAS  Google Scholar 

  22. Murray J, Ehlers A, Mayou RA (2002) Dissociation and post-traumatic stress disorder: two prospective studies of road traffic accident survivors. Br J Psychiatry 180:363–368

    Article  PubMed  Google Scholar 

  23. Sass H, Wittchen H-U, Zaudig M, Houben I (1996) Diagnostisches und statistisches manual psychischer störungen DSM-IV. Hogrefe, Göttingen

    Google Scholar 

  24. Schnyder U, Moergeli H, Trentz O, Klaghofer R, Buddeberg C (2001) Prediction of psychiatric morbidity in severely injured accident victims at one-year follow-up. Am J Respir Crit Care Med 164:653–656

    PubMed  CAS  Google Scholar 

  25. Shalev AY, Freedman S, Peri T, Brandes D, Sahar T, Orr SP, Pitman RK (1998) Prospective study of posttraumatic stress disorder and depression following trauma. Am J Psychiatry 155:630–637

    PubMed  CAS  Google Scholar 

  26. Ursano RJ, Fullerton CS, Epstein RS, Crowley B, Vance K, Kao TC, Baum A (1999) Peritraumatic dissociation and posttraumatic stress disorder following motor vehicle accidents. Am J Psychiatry 156:1808–1810

    PubMed  CAS  Google Scholar 

  27. Ursano RJ, Fullerton CS, Epstein RS, Crowley B, Kao TC, Vance K, Craig KJ, Dougall A, Baum A (1999) Acute and chronic posttraumatic stress disorder in motor vehicle accident victims. Am J Psychiatry 156:589–595

    PubMed  CAS  Google Scholar 

Download references

Acknowledgements

This project was conducted with the friendly support of GlaxoSmithKline, Germany.

Author information

Authors and Affiliations

  1. Department of Psychiatry and Psychotherapy, University of Schleswig-Holstein, Campus Luebeck, Ratzeburger Allee 160, 23538, Luebeck, Germany

    Manuela Kühn, Hans-Jürgen Rumpf, Jutta Backhaus & Fritz Hohagen

  2. Department of Psychology, Clinical Psychology and Psychotherapy, University of Zurich, Zurichbergstrasse 43, 8044, Zurich, Switzerland

    Ulrike Ehlert

  3. Carl-Friedrich-Flemming-Klinik, Helios Kliniken Schwerin, Wismarsche Straße 393-397, 19049, Schwerin, Germany

    Andreas Broocks

Authors
  1. Manuela Kühn
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Ulrike Ehlert
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Hans-Jürgen Rumpf
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Jutta Backhaus
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. Fritz Hohagen
    View author publications

    You can also search for this author in PubMed Google Scholar

  6. Andreas Broocks
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Ulrike Ehlert.

Rights and permissions

Reprints and permissions

About this article

Cite this article

Kühn, M., Ehlert, U., Rumpf, HJ. et al. Onset and maintenance of psychiatric disorders after serious accidents. Eur Arch Psychiatry Clin Neurosci 256, 497–503 (2006). https://doi.org/10.1007/s00406-006-0670-6

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s00406-006-0670-6

Keywords

Search

Navigation