Citation

Bryant RA, Nickerson A, Creamer M, O'Donnell M, Forbes D, Galatzer-Levy I, McFarlane AC, Silove D. Br. J. Psychiatry 2015; 206(5): 417-423.

Affiliation

Richard A. Bryant, PhD, School of Psychology, University of New South Wales and Brain Dynamics Centre, University of Sydney and Westmead Millennium Institute, Sydney, Australia; Angela Nickerson, PhD, School of Psychology, University of New South Wales, New South Wales, Australia; Mark Creamer, PhD, Meaghan O'Donnell, PhD, David Forbes, PhD, Australian Centre for Posttraumatic Mental Health, Department of Psychiatry, University of Melbourne, Melbourne; Isaac Galatzer-Levy, PhD, Department of Psychiatry, New York University, New York, USA; Alexander C. McFarlane, MD, Centre for Military and Veteran Health, University of Adelaide, Adelaide, Australia; Derrick Silove, MD, School of Psychiatry, University of New South Wales, New South Wales, Australia.

Copyright

(Copyright © 2015, Royal College of Psychiatry)

DOI

10.1192/bjp.bp.114.145516

PMID

25657356

Abstract

BACKGROUND Traumatic injuries affect millions of patients each year, and resulting post-traumatic stress disorder (PTSD) significantly contributes to subsequent impairment. Aims To map the distinctive long-term trajectories of PTSD responses over 6 years by using latent growth mixture modelling.

METHOD Randomly selected injury patients (n = 1084) admitted to four hospitals around Australia were assessed in hospital, and at 3, 12, 24 and 72 months. Lifetime psychiatric history and current PTSD severity and functioning were assessed.

RESULTS Five trajectories of PTSD response were noted across the 6 years: (a) chronic (4%), (b) recovery (6%), (c) worsening/recovery (8%), (d) worsening (10%) and (e) resilient (73%). A poorer trajectory was predicted by female gender, recent life stressors, presence of mild traumatic brain injury and admission to intensive care unit.

CONCLUSIONS These findings demonstrate the long-term PTSD effects that can occur following traumatic injury. The different trajectories highlight that monitoring a subset of patients over time is probably a more accurate means of identifying PTSD rather than relying on factors that can be assessed during hospital admission.

Language: en