Anxiety and depression disorders 5 years after severe injuries: a prospective follow-up study.

Individuals with severe injuries were investigated 5 years after the traumatic events, and predictors of anxiety and depression disorders were identified. Trauma victims were selected who had an Injury Severity Score of > or = 16 and were brought to all hospitals in the Mersey region and North Wales over 1 year. The 212 patients aged > or = 15 years who left the hospital alive and lived within an accessible distance of the study hospital in Warrington were contacted 5 years later and 158 (74.5%) received follow-up assessment. Thirty-eight subjects (36.9%) reported "definite" anxiety and/or depression disorders and, of these, only 21.1% reported taking psychotropic medications. Factors associated with anxiety and/or depression disorders at follow-up were: sequelae of head injury (i.e., cognitive problems, posttraumatic seizures, facial pain): writing impairment: disability due to thorax problems; and a new trauma during follow-up. Initial severity or types of injuries and overall residual disability rated by the investigator were not strong predictors of anxiety and/or depression disorders at follow-up.

[1]  A. Barsky Amplification, somatization, and the somatoform disorders. , 1992, Psychosomatics.

[2]  T. Rüedi,et al.  Five years' follow-up of severely injured ICU patients. , 1991, The Journal of trauma.

[3]  K. Hawton,et al.  Psychiatric Disorder in the General Hospital , 1986, British Journal of Psychiatry.

[4]  W. Hendrickse,et al.  Malignant Post‐Vietnam Stress Syndrome Revisited , 1996, The Journal of nervous and mental disease.

[5]  U. Malt,et al.  The Long-Term Psychiatric Consequences of Accidental Injury , 1988, British Journal of Psychiatry.

[6]  E. D. Schwarz,et al.  Malignant memories. Reluctance to utilize mental health services after a disaster. , 1992, The Journal of nervous and mental disease.

[7]  Judith Lewis Herman,et al.  Complex PTSD: A syndrome in survivors of prolonged and repeated trauma. , 1992 .

[8]  J. Grafman,et al.  Residual impairments and work status 15 years after penetrating head injury , 1993, Neurology.

[9]  Higgins Es,et al.  A review of unrecognized mental illness in primary care. Prevalence, natural history, and efforts to change the course. , 1994 .

[10]  S. Southwick,et al.  Childhood physical abuse and combat-related posttraumatic stress disorder in Vietnam veterans. , 1993, The American journal of psychiatry.

[11]  R. Mayou,et al.  Long-Term Outcome of Motor Vehicle Accident Injury , 1997, Psychosomatic medicine.

[12]  G. Canino,et al.  Somatic symptoms after a natural disaster: a prospective study. , 1992, The American journal of psychiatry.

[13]  S. Saravay,et al.  Psychological comorbidity and length of stay in the general hospital. , 1991, The American journal of psychiatry.

[14]  C. Herrmann International experiences with the Hospital Anxiety and Depression Scale--a review of validation data and clinical results. , 1997, Journal of psychosomatic research.

[15]  P. Myllynen,et al.  Is the treatment of the most severe multiply injured patients worth the effort? A follow-up examination 5 to 20 years after severe multiple injury. , 1990, The Journal of trauma.

[16]  D. Gorman,et al.  The epidemiology of major injuries in Mersey Region and North Wales. , 1995, Injury.

[17]  C. Duggan,et al.  Medium-Term Course of Disaster Victims , 1995, British Journal of Psychiatry.

[18]  B. A. van der Kolk,et al.  Childhood abuse and neglect and loss of self-regulation. , 1994, Bulletin of the Menninger Clinic.

[19]  B. Litz,et al.  Current and Lifetime Psychiatric Disorders among Veterans with War Zone‐Related Posttraumatic Stress Disorder , 1996, The Journal of nervous and mental disease.

[20]  J. Herman,et al.  Dissociation, somatization, and affect dysregulation: the complexity of adaptation of trauma. , 1996, The American journal of psychiatry.

[21]  N. Breslau,et al.  Traumatic events and posttraumatic stress disorder in an urban population of young adults. , 1991, Archives of general psychiatry.

[22]  J. Gunn,et al.  The Psychological Effects of Disaster at Sea , 1995, British Journal of Psychiatry.

[23]  Psychosocial and emotional sequelae of individuals with traumatic brain injury: a literature review and recommendations. , 1995 .

[24]  W. Haddon,et al.  The injury severity score: a method for describing patients with multiple injuries and evaluating emergency care. , 1974, The Journal of trauma.

[25]  Richard Mayou,et al.  Psychiatric consequences of road traffic accidents. , 1993, BMJ.

[26]  Psychological Consequences of the Kegworth Air Disaster , 1995, British Journal of Psychiatry.

[27]  S. Baker,et al.  The injury severity score: an update. , 1976, The Journal of trauma.

[28]  E. Kumpusalo,et al.  The Chernobyl accident and mental wellbeing — a population study , 1995, Acta psychiatrica Scandinavica.

[29]  R. Snaith,et al.  The Hospital Anxiety and Depression Scale , 1983 .

[30]  D. Gorman,et al.  Preventable deaths among major trauma patients in Mersey Region, North Wales and the Isle of Man. , 1996, Injury.

[31]  J P Bull,et al.  Measures of severity of injury. , 1975, Injury.

[32]  J. Martin,et al.  The Effect of Child Sexual Abuse on Social, Interpersonal and Sexual Function in Adult Life , 1994, British Journal of Psychiatry.

[33]  D. Boot,et al.  Disability after severe injury: five year follow up of a large cohort. , 1998, Injury.

[34]  A. Lobo,et al.  Psychiatric morbidity among medical out-patients in Spain: a case for new methods of classification. , 1988, Journal of psychosomatic research.