Predictive factors of chronic post-traumatic stress disorder 6 months after a road traffic accident

BackgroundThis study sets out to identify risk factors for post-traumatic stress disorder (PTSD) after a road traffic accident with a view to improving prevention.MethodsThe study used a prospective cohort of road traffic accident casualties. All subjects over 15 years of age were recruited in the course of an interview conducted while they were receiving care in a hospital of the Rhône area administrative département. Six months after their accident, they answered a self-administered postal questionnaire that included the Post-traumatic Check-List Scale (PCLS) in order to evaluate PTSD. Multivariate logistic regression analysis was conducted to compare those subjects with a PCLS score of 44 or over with those with a lower score, in order to identify factors that might be associated with PTSD.Results592 subjects (out of 1168) returned the 6-month questionnaire and 541 completed the PCLS test. One hundred subjects had a PCLS score ≥44, suggesting PTSD, and 441 subjects did not. The factors associated with PTSD were initial injury severity, post-traumatic amnesia, the feeling of not being responsible for their accident and persistent pain 6 months after it. A lower odds-ratio was associated with users of two-wheel than four-wheel motor vehicles (OR = 0.4; 0.2–0.9).ConclusionBesides predictive factors for PTSD (injury severity, post-traumatic amnesia and the feeling of not being responsible for their accident), our study suggested a reduced risk of PTSD among two-wheel motor vehicle users.

Research highlights▶ PTSD prevalence 6 months after the road traffic accident, on the PCLS test, was 18%. ▶ NISS and feeling of not being responsible for the accident were associated with PTSD. ▶ Post-traumatic amnesia was associated with PTSD. ▶ PTSD was strongly associated with persistence of pain 6 months after the accident. ▶ Our study might suggested a reduced risk of PTSD among two-wheel motor vehicle users.