Post-traumatic stress disorder associated with life-threatening motor vehicle collisions in the WHO World Mental Health Surveys

Authors

Dan J. Stein, University of Cape Town
Elie G. Karam, Balamand University
Victoria Shahly, Harvard University
Eric D. Hill, Harvard University
Andrew King, Harvard University
Maria Petukhova, Harvard University
Lukoye Atwoli, Aga Khan UniversityFollow
Evelyn J. Bromet, State University of New York at Stony Brook
Silvia Florescu, National School of Public Health, Management and Professional Development, Bucharest, Romania
Josep Maria Haro, Parc Sanitari Sant Joan de Déu, Centrosde Investigación Biomédica en Red de Salud Mental, Universitat deBarcelona, Barcelona, Spain

Document Type

Article

Department

Faculty of Health Sciences, East Africa

Abstract

Background: Motor vehicle collisions (MVCs) are a substantial contributor to the global burden of disease and lead to subsequent post-traumatic stress disorder (PTSD). However, the relevant literature originates in only a few countries, and much remains unknown about MVC-related PTSD prevalence and predictors.

Methods: Data come from the World Mental Health Survey Initiative, a coordinated series of community epidemiological surveys of mental disorders throughout the world. The subset of 13 surveys (5 in high income countries, 8 in middle or low income countries) with respondents reporting PTSD after life-threatening MVCs are considered here. Six classes of predictors were assessed: socio-demographics, characteristics of the MVC, childhood family adversities, MVCs, other traumatic experiences, and respondent history of prior mental disorders. Logistic regression was used to examine predictors of PTSD. Mental disorders were assessed with the fully-structured Composite International Diagnostic Interview using DSM-IV criteria.

Results: Prevalence of PTSD associated with MVCs perceived to be life-threatening was 2.5 % overall and did not vary significantly across countries. PTSD was significantly associated with low respondent education, someone dying in the MVC, the respondent or someone else being seriously injured, childhood family adversities, prior MVCs (but not other traumatic experiences), and number of prior anxiety disorders. The final model was significantly predictive of PTSD, with 32 % of all PTSD occurring among the 5 % of respondents classified by the model as having highest PTSD risk.

Conclusion: Although PTSD is a relatively rare outcome of life-threatening MVCs, a substantial minority of PTSD cases occur among the relatively small proportion of people with highest predicted risk. This raises the question whether MVC-related PTSD could be reduced with preventive interventions targeted to high-risk survivors using models based on predictors assessed in the immediate aftermath of the MVCs.

Comments

This work was published before the author joined Aga Khan University

Publication (Name of Journal)

BMC psychiatry

Recommended Citation

Stein, D. J., Karam, E. G., Shahly, V., Hill, E. D., King, A., Petukhova, M., Atwoli, L., Bromet, E. J., Florescu, S., Haro, J. M. (2016). Post-traumatic stress disorder associated with life-threatening motor vehicle collisions in the WHO World Mental Health Surveys. BMC psychiatry, 16(1), 1-14.
Available at: https://ecommons.aku.edu/eastafrica_fhs_mc_intern_med/165