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Posttraumatic Stress Among Hospitalized and Nonhospitalized Survivors of Serious Car Crashes: A Population-Based Study

Dr. Ameratunga and Dr. Tin Tin are affiliated with the Section of Epidemiology and Biostatistics, School of Population Health, Faculty of Medical and Health Sciences, University of Auckland, Private Bag 92019, Auckland Mail Centre, Auckland 1142, New Zealand (e-mail: s.ameratunga{at}auckland.ac.nz). Dr. Coverdale is with the Menninger Department of Psychiatry and Center for Medical Ethics, Baylor College of Medicine, Houston, Texas. Dr. Connor is with the Department of Social and Preventive Medicine, Dunedin School of Medicine, University of Otago, Dunedin, New Zealand. Dr. Norton is with The George Institute for International Health, University of Sydney, New South Wales, Australia.

OBJECTIVE: This study investigated the prevalence of posttraumatic stress among survivors of serious injury-producing car crashes. METHODS: This population-based prospective cohort study, conducted in New Zealand, recruited hospitalized car occupants (passengers and drivers) as well as nonhospitalized drivers after a crash in which at least one occupant was hospitalized. Fifty-nine hospitalized passengers (62%) and 209 drivers (72%) completed five- and 18-month interviews. The Impact of Event Scale assessed symptoms of posttraumatic stress. RESULTS: At five months 28% of hospitalized passengers, 24% of hospitalized drivers, and 24% of nonhospitalized drivers reported symptoms consistent with posttraumatic stress disorder. At 18 months, 23% of hospitalized passengers, 11% of hospitalized drivers, and 7% of nonhospitalized drivers reported significant levels of stress. CONCLUSIONS: Strategies to prevent disabling sequelae of crashes must address the needs of hospitalized and nonhospitalized survivors.

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