Association Between Posttraumatic Stress and Depressive Symptoms and Functional Outcomes in Adolescents Followed Up Longitudinally After Injury Hospitalization

Zatzick, Douglas; Jurkovich, Gregory J.; Fan, Ming; Grossman, David C.; Russo, Joan; Katon, Wayne; Rivara, Frederick P.

doi:10.1001/archpedi.162.7.642

Cited by 140 publications

(142 citation statements)

References 42 publications

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“…Previous research has shown that PTSD has a substantial impact on health-related quality of life (HRQoL), of adult hospitalized injury patients as was demonstrated by Holbrook et al in one of the few studies that addressed this matter [1,9]. Similar results were found among adolescents and children [10,11]. However, these studies were again restricted to victims at the higher end of the severity spectrum.…”

Section: Introductionmentioning

confidence: 66%

“…A study of patients with PTSD following cardiac arrest reported similar findings [27]. In another study among adolescent victims PTSD was associated with impairments in Role/Social Behavioral, Role/Social Physical, Bodily Pain, General Behavior, Mental Health, and General Health Perceptions subscales of the 87-item Child Health Questionnaire [11]. The resulting EQ-5D summary scores of injury patients with PTSD found in the current study are approximately in the range of: the utility scores that Holbrook et al derived with the Quality of Wellbeing scale [9].…”

Section: J Depress Anxietymentioning

confidence: 78%

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Posttraumatic Stress Disorder Following Injury: Trajectories and Impact on Health-Related Quality of Life

Haagsma¹

2013

J Depress Anxiety

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Background:Little is known about posttraumatic stress disorder (PTSD) trajectories of injury patients of all severity levels and external causes. The aim of our study was to assess prevalence rates, predictors, trajectories and impact on health-related quality of life (HRQoL) of PTSD 2.5, 5, 12 and 24 months post-injury.Methods:We selected a sample of 8,057 patients aged 15 years and older who attended the Emergency Department (ED) followed by either hospital admission or discharge to the home environment. The sample received postal questionnaires 2.5, 5, 12 and 24 months after treatment at the ED. The questionnaires included items regarding socio-demographics, EQ-5D to measure HRQoL, and the Impact of Event Scale-Revised (IESR). An IESR-score ≥ 33 was used as indication for the presence of PTSD.Results: 2,918 (36%) injury patients completed the 2.5 months follow-up survey. PTSD prevalence rate at 2.5 month follow-up was 9%. At 5, 12 and 24 month follow-up PTSD prevalence rates were 7%, 6% and 5% respectively. Comorbid disease, female gender and low educational level were the strongest independent predictors of PTSD. One in ten patients had PTSD at some point during 24 month follow-up. PTSD was associated with a significantly decreased HRQoL. Conclusions:We conclude that almost one in ten injury patients of all causes and severity levels treated at an ED suffer from PTSD symptoms, which is associated with a considerable decrease in HRQoL. PTSD symptoms may therefore raise a major barrier for full recovery of injury patients of even minor levels of severity.

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Section: Introductionmentioning

confidence: 66%

Section: J Depress Anxietymentioning

confidence: 78%

Posttraumatic Stress Disorder Following Injury: Trajectories and Impact on Health-Related Quality of Life

Haagsma¹

2013

J Depress Anxiety

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“…Children who incur an injury are at risk for developing post-traumatic stress disorder (PTSD) [2][3][4]. The severity of a child's injury does not predict PTSD [5,6], which can make it difficult for medical professionals to determine when a child will develop psychological symptoms.…”

Section: Introductionmentioning

confidence: 99%

After the injury: initial evaluation of a web-based intervention for parents of injured children

Marsac¹,

Kassam‐Adams²,

Hildenbrand³

et al. 2010

Health Education Research

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The purpose of this study was to survey parent knowledge of child injury reactions (including post-traumatic stress symptoms) and to evaluate parent satisfaction and learning outcomes following a video-or web-based intervention. Fifty parents of children ages 6-17 years who were injured within the past 2 months were recruited from emergency and inpatient settings. A repeated-measures experimental design was employed in which participants were assigned to either a web-based or video intervention. Parent knowledge was assessed preand post-intervention. Learning outcomes and satisfaction were evaluated post-intervention. Parents showed high levels (w70% accuracy) of knowledge about potential psychological injury reactions at baseline and post-intervention. In addition, post-intervention parents were able to generate new positive strategies to help their child recover and became more specific about types of reactions to monitor (e.g. avoidance). Participants reported high levels of satisfaction with both web and video interventions. While parents possess high levels of basic knowledge about child recovery from injury, the Web site and video tools provided concrete guidance that was useful in enhancing parent understanding of specific traumatic stress reactions to monitor in children post-injury.

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“…Automated screening for PTSD using known risk factors and characteristics of the index injury is also feasible. 20,38 In adolescents, PTSD is associated with a broad spectrum of functional impairments across multiple domains. 20 Although stepped care interventions for the prevention and treatment of PTSD in injured adults have been effective, 39,40 initial interventions for the prevention of acute stress symptoms and PTSD in children and adolescents have not been shown to be effective 41 and additional clinical trials are clearly needed.…”

Section: Discussionmentioning

confidence: 99%

Parental Injury and Psychological Health of Children

Rivara

McCarty

Shandro³

et al. 2014

Pediatrics

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WHAT'S KNOWN ON THIS SUBJECT:Injuries sustained by parents in combat can also have a variety of psychological effects on children in the family. However, there has been little research on the effect of parental injury on children in the civilian setting. WHAT THIS STUDY ADDS:The effects of injury of parents impacted children' s functioning by negatively affecting the healthrelated quality of life of the injured children, over and above the effect of any injury itself to the child. Injury to the parent also increased the likelihood of his or her uninjured children having PTSD symptoms 5 months after the parent' s injury. abstract OBJECTIVE: To determine how parental injury affects the psychological health and functioning of injured as well as uninjured children. METHODS:We recruited 175 parent-child dyads treated at a regional trauma center in 4 groups: parent and child both injured in the same event, child-only injured, parent-only injured, and neither parent nor child met criteria for significant injury. The preinjury health and functioning of parents and children were assessed with follow-up at 5 and 12 months. RESULTS:Parents who were injured themselves showed higher levels of impairment in activities of daily living, quality of life, and depression at both follow-up assessments than parents who were not injured. Children in dyads with both parent and child injured had the highest proportion of posttraumatic stress disorder (PTSD) symptoms at both 5 and 12 months. In addition, children with an injured parent but who were not injured themselves were more likely to report PTSD symptoms at 5 months.CONCLUSIONS: There were bidirectional effects of parental and child injury on the outcomes of each other. Injuries to the parent negatively affected the health-related quality of life of the injured children, over and above the effect of the injury itself on the child. Of great concern is the effect of parental injury on risk of stress and PTSD among uninjured children in the home. Pediatrics 2014;134:e88-e97 AUTHORS:

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Association Between Posttraumatic Stress and Depressive Symptoms and Functional Outcomes in Adolescents Followed Up Longitudinally After Injury Hospitalization

Cited by 140 publications

References 42 publications

Posttraumatic Stress Disorder Following Injury: Trajectories and Impact on Health-Related Quality of Life

Posttraumatic Stress Disorder Following Injury: Trajectories and Impact on Health-Related Quality of Life

After the injury: initial evaluation of a web-based intervention for parents of injured children

Parental Injury and Psychological Health of Children

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