Studies exploring potential predictors of post-traumatic stress disorder (PSTD) following major trauma have resulted in varied conclusions. While a number of risk factors such as injury severity, demographic factors and compensation-related factors have been identified, none is strong enough to reliably predict which patient will develop the disorder.
PTSD is characterized by flashbacks of the event, anxiety, and social withdrawal. Victims of major trauma are at significant risk of developing PTSD, with about 15% developing the disorder within a year of the injury.
A study in the July issue of ANZ Journal of Surgery titled "Predictors of Post-Traumatic Stress Disorder following Major Trauma" by Professor Ian Harris et al. argues that the lack of consistency of previous PTSD studies is a result of methodological flaws such as selection bias, and poorly defined diagnostic criteria.
The authors investigated the association between injury severity, demographic and compensation-related factors with the development of PTSD and found that the disorder was also independently associated with having an unsettled compensation claim, their use of lawyer services and the placement of blame on others for the injury.
Another study in the same issue of ANZ Journal of Surgery claims that there is no existing risk factor model that enables an accurate prediction of how patients will be affected psychiatrically in the aftermath of the injury.
Author of "Predictors of Post-traumatic Stress Disorder after Major Injury", Professor Alexander Cowell McFarlane says, "The inconsistencies in PTSD predicators suggest the pivotal role of health-care professionals in the identification of patients at risk of developing psychiatric disorders."
He adds, "While risk factors should be considered, the traumatic events are sufficient to elicit symptoms in the individuals. Ultimately, it is the surgeons’ skill in the management of the psychological recovery that will play a critical role in the patients’ rehabilitation".
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