A prospective study of the onset of PTSD symptoms in the first month after trauma exposure
Department of Psychiatry/Division of Crisis and Disaster Psychiatry, University of Texas Southwestern Medical Center, Dallas, TX, USA
VA North Texas Health Care System, Departments of Psychiatry and Surgery/Division of Emergency Medicine, University of Texas Southwestern Medical Center, Dallas, TX, USA
Department of Psychiatry/Division of Crisis and Disaster Psychiatry, University of Texas Southwestern Medical Center, Dallas, TX, USAEdward L. Spitznagel, PhD
Department of Mathematics, Division of Biostatistics, Washington University in St. Louis, St. Louis, MO, USA
BACKGROUND: The course of posttraumatic stress disorder (PTSD) symptoms in the month after trauma exposure has not been determined adequately. Symptom group C (avoidance/numbing) has been identified retrospectively as a marker for PTSD, but prospective studies are needed to determine whether these symptoms can provide substantially earlier identification of those who will have PTSD 1 month after trauma exposure.
METHODS: We evaluated 42 patients hospitalized for traumatic injuries over the first post-injury month to track development of posttraumatic symptoms.
RESULTS: Symptoms emerged rapidly, with group B (intrusion) and group D (hyperarousal) symptoms occurring earlier than group C symptoms. At 1 week, group C criteria accurately predicted who would develop PTSD by 1 month, and by 2 weeks, group C criteria also predicted who would not develop PTSD by 1 month.
CONCLUSIONS: The findings, if replicated, may permit earlier identification of PTSD and more timely, appropriate treatment.
KEYWORDS: trauma, posttraumatic stress disorder, PTSD, emergency medicine
ANNALS OF CLINICAL PSYCHIATRY 2013;25(2):E8-E17CORRESPONDENCE: Jeannie B. Whitman, PhD Department of Psychiatry University of Texas Southwestern Medical Center at Dallas 6363 Forest Park Road, Suite 651 Dallas, TX 75390 USA E-MAIL: Jeannie.Whitman@UTSouthwestern.eduAnnals of Clinical Psychiatry ©2013 Frontline Medical Communications Inc.