Beyond the neglect of psychological consequences: post-traumatic stress disorder increases the non-fatal burden of injury by more than 50%. Issue 1 (6th October 2010)

• Record Type: Journal Article
• Authors: Haagsma, Juanita A; Polinder, Suzanne; Toet, Hidde; Panneman, Martien; Havelaar, Arie H; Bonsel, Gouke J; van Beeck, Ed F
• Is Part Of: Injury prevention. Volume 17:Issue 1(2011)
• Page Start: 21
• Page End: 26
• Publication Date: 2010-10-06
• Subjects: Disability -- psychological -- public health -- sequelae; Children's accidents -- Prevention -- Periodicals; Accidents -- Prevention -- Periodicals; 617.1
• DOI: 10.1136/ip.2010.026419
• Languages: English
• ISSNs: 1353-8047

Abstract

Abstract : Background: Psychological consequences such as post-traumatic stress disorder (PTSD) are currently neglected in burden-of-injury calculations. Aim: To assess the disease burden of PTSD due to unintentional injury and compare this health loss with physical injury consequences. Methods: From literature sources, the prevalence of PTSD at four follow-up periods (<3 months, 3–6 months, 7–12 months and >12 months) was estimated. The uncertainty of the estimated PTSD prevalence was modelled by a Bayesian approach. The prevalence rates were then linked to national data on unintentional injury, disability weights and duration to estimate the incidence and disability-adjusted life years (DALY) resulting from PTSD in addition to physical injury consequences. Results: The data suggest that PTSD prevalence among injury victims decreases over time. The average PTSD prevalence at <3 months follow-up was 21% (90% credibility interval (CI) 17% to 24%) for patients presenting at the emergency department and 30% (90% CI 27% to 33%) for patients who were hospitalised, tapering down after 12 months to 4% (90% CI 3% to 5%) and 6% (90% CI 4% to 10%), respectively. These estimates translate into 191 000 (90% CI 161 000 to 222 000) cases of PTSD per year in the Dutch population (1.2%) due to unintentional injury. Including PTSD increases the non-fatal burden of disease of unintentional injuries by 53% (from 116 000 to 178 000 DALYs (90% CI 150 000 to 217 000)). Conclusions: Ignoring PTSD in burden-of-injury studies results in a considerable underestimation of the burden of injury. This may affect resource allocation and the identification of important prevention priorities.