Prevalence of posttraumatic stress disorder and major depression after trauma center hospitalization

Abstract

Background: Individuals hospitalized after physical trauma are at heightened risk for mental disorders. We examined prevalence rates of both posttraumatic stress disorder (PTSD) and major depression at 6 and 12 months in a sample of 677 individuals experiencing different types of trauma who were representative of physical trauma survivors hospitalized in Los Angeles County trauma centers. Demographic and injury-related risk factors for these disorders were also evaluated.

Methods: Bivariate logistic regressions estimated risk for PTSD and depression at either 6 or 12 months associated with baseline risk factors.

Results: At 6 months, 31% of participants met screening criteria for probable PTSD and 31% met criteria for probable depression. At 12 months, 28% and 29% met criteria for PTSD and depression, respectively. There were also high rates of comorbidity; depression and PTSD co-occurred in 21% of individuals at 6 months and in 19% of patients at 12 months. Bivariate logistic regressions indicated that preexisting disability and lower education were associated with higher odds of PTSD at either 6 or 12 months. African Americans and Hispanics had higher odds of PTSD compared with non-Hispanic Caucasians. Assault-related injury (versus accident), more severe injury, and longer hospitalizations were also associated with greater odds of PTSD. By contrast, higher odds of depression at 6 or 12 months were only associated with preexisting disability, losing consciousness, more severe injury, and longer hospitalizations.

Conclusions: Key demographic and injury characteristics may enhance identification of at-risk trauma survivors who would benefit from targeted screening, patient education, and early intervention efforts.