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Kovacevic J, Miskulin M, Degmecic D, Vcev A, Leovic D, Sisljagic V, Simic I, Palenkic H, Vcev I, Miskulin I. Predictors of Mental Health Outcomes in Road Traffic Accident Survivors. J Clin Med 2020; 9:jcm9020309. [PMID: 31979086 PMCID: PMC7074414 DOI: 10.3390/jcm9020309] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/30/2019] [Revised: 01/18/2020] [Accepted: 01/19/2020] [Indexed: 11/16/2022] Open
Abstract
Mental health outcomes of road traffic accidents (RTAs) are always investigated in assessments of those involved. The aim of this study was to investigate the psychological consequences and associated factors in all RTA survivors, irrelevant of their injury status. A cohort of 155 people was assessed one month after experiencing a RTA using self-reported measures for posttraumatic stress disorder (PTSD), depression, and anxiety. Associations between mental health outcomes and sociodemographic factors, pre-RTA health status, injury-related factors, and RTA details were analyzed. RTA survivors reported substantial rates of PTSD (32.3%) and depression (17.4%) symptoms, and low rates of anxiety (5.8%). Symptoms of depression were associated with below-average self-perceived economic status, irreligiousness, medication use, psychiatric medication use, and injury-related factors. PTSD symptoms were associated with female gender, below-average self-perceived economic status, previous psychiatric illness, medication use, psychiatric medication use, not being at fault in the relevant RTA, claiming compensation, and injury-related factors. Anxiety symptoms were associated with previous chronic or psychiatric illness, previous permanent pain, psychiatric medication use, and self-perceived threat to life, but not with sustaining injury. Along with the evaluation and treatment of RTA injuries, health care providers should evaluate the pre-RTA health status of all RTA victims. Psychological support to those at risk may prevent psychological disorders after RTAs.
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Affiliation(s)
- Jelena Kovacevic
- Institute of emergency medicine of the Vukovar-Srijem County, 32 100 Vinkovci, Croatia;
- Faculty of Medicine Osijek, Josip Juraj Strossmayer University of Osijek, 31 000 Osijek, Croatia; (M.M.); (D.D.); (A.V.); (D.L.); (V.S.); (I.S.); (H.P.)
| | - Maja Miskulin
- Faculty of Medicine Osijek, Josip Juraj Strossmayer University of Osijek, 31 000 Osijek, Croatia; (M.M.); (D.D.); (A.V.); (D.L.); (V.S.); (I.S.); (H.P.)
| | - Dunja Degmecic
- Faculty of Medicine Osijek, Josip Juraj Strossmayer University of Osijek, 31 000 Osijek, Croatia; (M.M.); (D.D.); (A.V.); (D.L.); (V.S.); (I.S.); (H.P.)
- Department of Psychiatry, University Hospital Osijek, 31000 Osijek, Croatia
| | - Aleksandar Vcev
- Faculty of Medicine Osijek, Josip Juraj Strossmayer University of Osijek, 31 000 Osijek, Croatia; (M.M.); (D.D.); (A.V.); (D.L.); (V.S.); (I.S.); (H.P.)
- Faculty of Dental Medicine and Health Osijek, Josip Juraj Strossmayer University of Osijek, 31 000 Osijek, Croatia
- Department of Internal Medicine, University Hospital Osijek, 31000 Osijek, Croatia
| | - Dinko Leovic
- Faculty of Medicine Osijek, Josip Juraj Strossmayer University of Osijek, 31 000 Osijek, Croatia; (M.M.); (D.D.); (A.V.); (D.L.); (V.S.); (I.S.); (H.P.)
| | - Vladimir Sisljagic
- Faculty of Medicine Osijek, Josip Juraj Strossmayer University of Osijek, 31 000 Osijek, Croatia; (M.M.); (D.D.); (A.V.); (D.L.); (V.S.); (I.S.); (H.P.)
- Department of Surgery, University Hospital Osijek, 31000 Osijek, Croatia
| | - Ivana Simic
- Faculty of Medicine Osijek, Josip Juraj Strossmayer University of Osijek, 31 000 Osijek, Croatia; (M.M.); (D.D.); (A.V.); (D.L.); (V.S.); (I.S.); (H.P.)
- Institute of Public Health for the Osijek-Baranja County, 31 000 Osijek, Croatia
| | - Hrvoje Palenkic
- Faculty of Medicine Osijek, Josip Juraj Strossmayer University of Osijek, 31 000 Osijek, Croatia; (M.M.); (D.D.); (A.V.); (D.L.); (V.S.); (I.S.); (H.P.)
- Department of Surgery, General Hospital Slavonski Brod, 35 000 Slavonski Brod, Croatia
| | - Ivan Vcev
- Department of Humanities, University of Zadar, 23 000 Zadar, Croatia;
| | - Ivan Miskulin
- Faculty of Medicine Osijek, Josip Juraj Strossmayer University of Osijek, 31 000 Osijek, Croatia; (M.M.); (D.D.); (A.V.); (D.L.); (V.S.); (I.S.); (H.P.)
- Correspondence: ; Tel.: +385-91-224-1500
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Fekadu W, Mekonen T, Belete H, Belete A, Yohannes K. Incidence of Post-Traumatic Stress Disorder After Road Traffic Accident. Front Psychiatry 2019; 10:519. [PMID: 31379631 PMCID: PMC6659351 DOI: 10.3389/fpsyt.2019.00519] [Citation(s) in RCA: 20] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/14/2018] [Accepted: 07/01/2019] [Indexed: 11/13/2022] Open
Abstract
Background: Post-traumatic stress disorder (PTSD) occurs after exposure to actual or threatened death, serious injury, or sexual violence. Road traffic accident (RTA) is one of the traumatic experiences, which may result in PTSD. But treatment is mainly concentrated on physical health. This may be due to a lack of evidence in low-income countries. Aim: To determine the incidence level and identify risk factors of PTSD after RTA. Methods: Longitudinal panel study was done to assess the incidence of PTSD after RTA. The study was conducted in three orthopedic settings of Bahir Dar town Northwest, Ethiopia. The study was on 299 adult car accident survivors. PTSD Checklist (PCL) civilian version, Sheehan disability assessment scale, Patient Health Question (PHQ-2), and Alcohol Use Disorder Identification Test (AUDIT) were instruments to assess the outcome and associated factors. The generalized linear model with Poisson log-linear method was applied to identify associated factors. Ethical clearance was obtained from Bahir Dar University. Individuals with PTSD symptoms were linked to the psychiatric clinic. Result: One hundred thirty-nine (46.5%) participants had at least three extremely severe symptoms that fulfil criteria B, C, and D of Diagnostic Statistical Manual IV of PTSD. The most frequent severe symptoms were having repeated, disturbing memories, thoughts, or images. Two hundred ten (70.2%) participants reported the extreme impact of the accident on work or schooling and 156 (51.9%) reported extreme problems in social functioning. Alcohol dependence, hazardous alcohol consumption, and harmful use were reported by 7.9%, 15.1%, and 4.7% of the participants, respectively. In the final model witnessing death, severe sleep problem and severe impairment in family functioning were significantly associated with PTSD. Conclusion: Nearly half of RTA survivors develop PTSD. Clinicians need to link these patients to the psychiatry clinic. Special attention should be given to patients who witnessed death, with a serious disability, and previous psychiatric history.
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Affiliation(s)
- Wubalem Fekadu
- Psychiatry Department, School of Medicine, College of Medicine and Health Sciences, Bahir Dar University, Bahir Dar, Ethiopia
- Psychiatry Department, School of Medicine, College of Health Sciences, Addis Ababa University, Addis Ababa, Ethiopia
| | - Tesfa Mekonen
- Psychiatry Department, School of Medicine, College of Medicine and Health Sciences, Bahir Dar University, Bahir Dar, Ethiopia
| | - Habte Belete
- Psychiatry Department, School of Medicine, College of Medicine and Health Sciences, Bahir Dar University, Bahir Dar, Ethiopia
| | - Amsalu Belete
- College of Health Sciences, Debre Tabor University, Debre Tabor, Ethiopia
| | - Kalkidan Yohannes
- Department of Psychiatry, College of Medicine and Health Sciences, Dilla University, Dilla, Dilla, Ethiopia
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Abstract
BACKGROUND The psychological response of injured people after traffic accidents includes stress and depression. PURPOSE To assess orthopaedic patients' stress, depression, and satisfaction with life after traffic accidents in Greece. METHODS Descriptive, longitudinal, correlational study. Patients' background factors, injury severity, scores on the Impact of Events Scale-Revised (IES-R), the Center for Epidemiologic Studies Depression (CES-D) Scale, and the Satisfaction With Life Quality (SWLQ) Scale were recorded. The principles of the Declaration of Helsinki were applied. RESULTS In total, 60 patients participated in this study during hospitalization following a road traffic accident and 40 patients at 6 months after. Participants were mostly men (75%) with severe injuries (50%). The IES-R score at 6 months was significantly lower than during hospitalization. One out of 3 people had a CES-D score, which is considered of clinical significance. The SWLQ scores were considered high. CONCLUSION As posttraumatic stress and depression seem to affect a considerable percentage of people involved in road traffic accidents in Greece, these individuals should be assessed for posttraumatic stress and depression while still hospitalized.
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Krishnan B, Rajkumar RP. Psychological Consequences of Maxillofacial Trauma in the Indian Population: A Preliminary Study. Craniomaxillofac Trauma Reconstr 2017; 11:199-204. [PMID: 30087749 DOI: 10.1055/s-0037-1604426] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/18/2016] [Accepted: 04/02/2017] [Indexed: 02/06/2023] Open
Abstract
The aim of this article is to identify the prevalence of posttraumatic psychological symptoms following maxillofacial trauma among an Indian population sample and assess changes in these symptoms over a period of time. Forty-eight adult patients were assessed within 2 weeks of injury with two follow-up visits (4-6 weeks and 12-14 weeks). Patients were administered three self-reporting questionnaires in local language (GHQ-12; HADS; TSQ) on all occasions. Relevant sociodemographic and clinical data were obtained. Forty patients were included in the final analysis. Emotional distress was present in nine participants and five participants satisfied the TSQ criteria for a diagnosis of stress disorder. Anxiety and depression were observed in 10 and 4 patients, respectively. Characteristics associated with abnormal high scores included substance abuse, low education and income levels, facial scars, and complications needing additional intervention. These findings reveal the abnormal psychological response to maxillofacial trauma in immediate and follow-up periods. The use of such screening tools can be considered by the maxillofacial surgeon for early identification of psychological symptoms and referral to the psychiatrist.
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Affiliation(s)
- Balasubramanian Krishnan
- Department of Dentistry, Jawaharlal Institute of Postgraduate Medical Education and Research, Pondicherry, Pondicherry, India
| | - Ravi Philip Rajkumar
- Department of Psychiatry, Jawaharlal Institute of Postgraduate Medical Education and Research, Pondicherry, Pondicherry, India
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Herta DC, Brîndas P, Trifu R, Cozman D. Risk and resilience factors of persons exposed to accidents. ACTA ACUST UNITED AC 2016; 89:257-66. [PMID: 27152078 PMCID: PMC4849385 DOI: 10.15386/cjmed-547] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/27/2015] [Accepted: 09/07/2015] [Indexed: 12/02/2022]
Abstract
Background and aims Resilience encompasses factors promoting effective functioning in the context of adversity. Data regarding resilience in the wake of accidental trauma is still scarce. The aim of the current study is to comparatively assess adaptive, life – promoting factors in persons exposed to motor vehicle accidents (MVA) vs. persons exposed to other types of accidents, and to identify psychological factors of resilience and vulnerability in this context of trauma exposure. Methods We assessed 93 participants exposed to accidents out of 305 eligible patients from the Clinical Rehabilitation Hospital and Cluj County Emergency Hospital. The study used Reasons for Living Inventory (RFL) and Life Events Checklist. Scores were comparatively assessed for RFL items, RFL scale and subscales in participants exposed to motor vehicle accidents (MVA) vs. participants exposed to other life – threatening accidents. Results Participants exposed to MVA and those exposed to other accidents had significantly different scores in 7 RFL items. Scores were high in 4 out of 6 RFL subscales for both samples and in most items comprising these subscales, while in the other 2 subscales and in some items comprising them scores were low. Conclusions Low fear of death, physical suffering and social disapproval emerge as risk factors in persons exposed to life – threatening accidents. Love of life, courage in life and hope for the future are important resilience factors after exposure to various types of life – threatening accidents. Survival and active coping beliefs promote resilience especially after motor vehicle accidents. Coping with uncertainty are more likely to foster resilience after other types of life – threatening accidents. Attachment of the accident victim to family promotes resilience mostly after MVA, while perceived attachment of family members to the victim promotes resilience after other types of accidents.
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Affiliation(s)
- Dana-Cristina Herta
- Medical Psychology Department, Iuliu Hatieganu University of Medicine and Pharmacy, Cluj - Napoca, Romania
| | - Paula Brîndas
- Medical Psychology Department, Iuliu Hatieganu University of Medicine and Pharmacy, Cluj - Napoca, Romania
| | - Raluca Trifu
- Medical Psychology Department, Iuliu Hatieganu University of Medicine and Pharmacy, Cluj - Napoca, Romania; Lucian Blaga Central University Library, Cluj-Napoca, Romania
| | - Doina Cozman
- Medical Psychology Department, Iuliu Hatieganu University of Medicine and Pharmacy, Cluj - Napoca, Romania
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