Journal Article

Post-traumatic stress disorder associated with life-threatening motor vehicle collisions in the WHO World Mental Health Surveys

Karam, Aimee, Navarro-Mateu, Fernando, Kessler, Ronald C., Petukhova, Maria, Karam, Elie G., Haro, Josep Maria, King, Andrew, Hill, Eric D., Torres, Yolanda, Zaslavsky, Alan M., Hinkov, Hristo, Medina-Mora, María Elena, Stein, Dan J., Florescu, Silvia, Shalev, Arieh, Atwoli, Lukoye, Bromet, Evelyn J., Shahly, Victoria, Piazza, Marina

2016

Overview

Background Motor vehicle collisions (MVCs) are a substantial contributor to the global burden of disease and lead to subsequent post-traumatic stress disorder (PTSD). However, the relevant literature originates in only a few countries, and much remains unknown about MVC-related PTSD prevalence and predictors. Methods Data come from the World Mental Health Survey Initiative, a coordinated series of community epidemiological surveys of mental disorders throughout the world. The subset of 13 surveys (5 in high income countries, 8 in middle or low income countries) with respondents reporting PTSD after life-threatening MVCs are considered here. Six classes of predictors were assessed: socio-demographics, characteristics of the MVC, childhood family adversities, MVCs, other traumatic experiences, and respondent history of prior mental disorders. Logistic regression was used to examine predictors of PTSD. Mental disorders were assessed with the fully-structured Composite International Diagnostic Interview using DSM-IV criteria. Results Prevalence of PTSD associated with MVCs perceived to be life-threatening was 2.5 % overall and did not vary significantly across countries. PTSD was significantly associated with low respondent education, someone dying in the MVC, the respondent or someone else being seriously injured, childhood family adversities, prior MVCs (but not other traumatic experiences), and number of prior anxiety disorders. The final model was significantly predictive of PTSD, with 32 % of all PTSD occurring among the 5 % of respondents classified by the model as having highest PTSD risk. Conclusion Although PTSD is a relatively rare outcome of life-threatening MVCs, a substantial minority of PTSD cases occur among the relatively small proportion of people with highest predicted risk. This raises the question whether MVC-related PTSD could be reduced with preventive interventions targeted to high-risk survivors using models based on predictors assessed in the immediate aftermath of the MVCs.

• Publisher: BioMed Central,BioMed Central Ltd,Springer Nature B.V
• Subject: Accidents de circulació / Accidents, Traffic - psychology / Adolescent / Adult / Anxiety disorders / Behavior disorders / Child / Child, Preschool / Conduct disorder / Diagnosis / Diagnostic and Statistical Manual of Mental Disorders / Female / Health aspects / Health Surveys / Humans / Infant / Life Change Events / Male / Medicine / Medicine & Public Health / Mental disorders / Mental health / Organització Mundial de la Salut / Post traumatic stress disorder / Prevalence / Psychiatry / Psychotherapy / Research Article / Risk factors / Salut mental / Stress and anxiety / Stress Disorders, Post-Traumatic - epidemiology / Stress Disorders, Post-Traumatic - psychology / Surveys / Surveys and Questionnaires / Traffic accidents / Trastorn per estrès posttraumàtic / Young Adult