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Exploration of Delayed-Onset Posttraumatic Stress Disorder After Severe Injury.
MedLine Citation:
PMID:  23197845     Owner:  NLM     Status:  Publisher    
ObjectiveThe first aim of this work was to conduct a rigorous longitudinal study to identify rates of delayed-onset posttraumatic stress disorder (PTSD) in a sample of patients with severe injury. The second aim was to determine what variables differentiated delayed-onset PTSD from chronic PTSD.MethodsRandomly selected patients with injury who were admitted to four hospitals around Australia were recruited to the study (N = 834) and assessed in the acute care hospital, at 3 months, and at 12 months. A structured clinical interview was used to assess PTSD at each time point.ResultsSeventy-three patients (9%; n = 73) had PTSD at 12 months. Of these, 39 (53%) were classified as having delayed-onset PTSD. Furthermore, 22 (56%) patients with delayed-onset PTSD had minimal PTSD symptoms at 3 months (i.e., they did not have partial/subsyndromal PTSD at 3 months). The variables that differentiated delayed-onset PTSD from chronic PTSD were greater injury severity (odds ratio [OR] = 1.13; 95% confidence interval [CI] = 1.02-1.26), lower anxiety severity at 3 months (OR = 0.73; 95% CI = 0.61-0.87), and greater pain severity at 3 months (OR = 1.39; 95% CI = 1.06-1.84).ConclusionsDelayed-onset PTSD occurred frequently in this sample. Approximately half of the patients with delayed-onset PTSD had minimal PTSD symptoms at 3 months; therefore, their delayed-onset PTSD could not be accounted for by a small number of fluctuating symptoms. As we move toward DSM-V, it is important that research continues to explore the factors that underpin the development of delayed-onset PTSD.
Meaghan L O'Donnell; Tracey Varker; Mark Creamer; Susan Fletcher; Alexander C McFarlane; Derrick Silove; Richard A Bryant; David Forbes
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Publication Detail:
Type:  JOURNAL ARTICLE     Date:  2012-11-28
Journal Detail:
Title:  Psychosomatic medicine     Volume:  -     ISSN:  1534-7796     ISO Abbreviation:  Psychosom Med     Publication Date:  2012 Nov 
Date Detail:
Created Date:  2012-11-30     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  0376505     Medline TA:  Psychosom Med     Country:  -    
Other Details:
Languages:  ENG     Pagination:  -     Citation Subset:  -    
Australian Center for Posttraumatic Mental Health (M.L.O., T.V., M.C., S.F., D.F.), East Melbourne, Victoria; Department of Psychiatry (M.L.O., T.V., M.C., S.F., D.F.), University of Melbourne, Parkville, Victoria; School of Psychology (R.A.B.) and Department of Psychiatry (D.S.), University of New South Wales, Sydney, New South Wales; Center for Traumatic Stress (A.C.M.), University of Adelaide, Adelaide, South Australia; and Psychiatry Research and Teaching Unit (D.S.), Mental Health Center, Liverpool, New South Wales, Australia.
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