Posttraumatic Distress, Alcohol Disorders, and Recurrent Trauma Across Level 1 Trauma Centers

Abstract

High levels of posttraumatic distress, recurrent trauma, and alcohol abuse/dependence were present in more than half of acute care inpatients. Early mental health screening and intervention procedures that target both PTSD and alcohol use should be developed for acute care settings.

Collaborative Care Interventions in General Trauma Patients

“…51 The Harborview pilot study tested an early combined intervention that included continuous master's level case management over the first six months post-injury and evidence-based medication and psychotherapy for PTSD delivered by MD/PhD mental health specialists. As with the pilot study, inclusion criteria for the Harborview pilot remained extremely broad.…”

“…2,24,33 Physical injury as the result of a traumatic event increases the risk for experiencing psychiatric symptoms, including depression and post-traumatic stress disorder (PTSD), as well as other psychosomatic symptoms, or those without any known medical cause. 6,8,10,11,18,13,20,22,43,48,51,52,54,49 In analysis of data from the National Study on the Costs and Outcomes of Trauma (NSCOT), the largest study to date assessing functional and work outcomes after an injury, researchers found that 23 percent of injury survivors were continuing to experience PTSD symptoms a year post-injury. 55 In addition, research indicates between 20-50% of trauma patients on surgical wards fit criteria for current or long term substance abuse.…”

“…53 Intervention protocols that assist patients in addressing these concerns appear to allow patients to focus more on any needed psychiatric treatment. 53,51 …”

“…4 However, with current standards of practice at acute care facilities, few patients receive mental health evaluations or treatment, even though more than fifty percent of trauma survivors experience high levels of emotional distress associated with PTSD, depression, and substance use disorders and experience symptoms while on the ward. 51 Patients rarely seek out mental health services on their own after hospital discharge. 5,16,25 , 1 Therefore, although there are many evidence-based interventions available for patients with PTSD symptoms, these are rarely practiced with trauma patients post-injury.…”

“…21,40 An estimated ten to forty percent of patients presenting to acute medical centers after a physical injury develop symptoms associated with PTSD. 13,22,42,52,58,51 In a 2007 study, Wong, et al, worked with facial trauma survivors to assess acute care needs and psychiatric symptoms post-injury. Through psychiatric assessments, 34% of study participants showed symptoms of PTSD, and 35% of participants expressed symptoms of depression.…”