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The efficacy of initial hydrocortisone administration at preventing posttraumatic distress in adult trauma patients: a randomized trial

Published online by Cambridge University Press:  05 April 2013

Douglas L. Delahanty ,
Crystal Gabert-Quillen ,
Sarah A. Ostrowski ,
Nicole R. Nugent ,
Beth Fischer ,
Adam Morris ,
Roger K. Pitman ,
John Bon  and
William Fallon Jr.
Douglas L. Delahanty*
Affiliation:
Kent State University, Department of Psychology, Kent, Ohio, USA Department of Trauma Services, Akron, Ohio, USA
Crystal Gabert-Quillen
Affiliation:
Kent State University, Department of Psychology, Kent, Ohio, USA
Sarah A. Ostrowski
Affiliation:
NeuroDevelopmental Science Center, Akron Children's Hospital, Akron, Ohio, USA
Nicole R. Nugent
Affiliation:
Alpert Brown Medical School, RIH Bradley/Hasbro Children's Research Center, Providence, Rhode Island, USA
Beth Fischer
Affiliation:
The Center for Family Safety and Healing, Columbus, Ohio, USA
Adam Morris
Affiliation:
Kent State University, Department of Psychology, Kent, Ohio, USA
Roger K. Pitman
Affiliation:
Harvard Medical School, Massachusetts General Hospital, Boston, Massachusetts, USA
John Bon
Affiliation:
Department of Pharmacy, Summa Health System, Akron, Ohio, USA
William Fallon Jr.
Affiliation:
Department of Trauma Services, Akron, Ohio, USA
*
*Address for correspondence: Douglas Delahanty, Department of Psychology, 144 Kent Hall, Kent, OH 44242, USA. (Email ddelahan@kent.edu)
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Abstract

Objective/Introduction

Secondary pharmacological interventions have shown promise at reducing the development of posttraumatic stress disorder symptoms (PTSS) in preclinical studies. The present study examined the preliminary efficacy of a 10-day low-dose (20 mg bid) course of hydrocortisone at preventing PTSS in traumatic injury victims.

Methods

Sixty-four traumatic injury patients (34% female) were randomly assigned in a double-blind protocol to receive either a 10-day course of hydrocortisone or placebo initiated within 12 hours of the trauma. One-month and 3-months posttrauma participants completed an interview to assess PTSS and self-report measures of depression and health-related quality of life.

Results

Hydrocortisone recipients reported fewer PTSD and depression symptoms, and had greater improvements in health-related quality of life during the first 3 months posttrauma than did placebo recipients. Hydrocortisone recipients who had never received prior mental health treatment had the lowest PTSD scores.

Conclusion

Low-dose hydrocortisone may be a promising approach to the prevention of PTSD in acutely injured trauma patients, and may be particularly efficacious in acutely injured trauma victims without a history of significant psychopathology.

Type
Original Research
Information
CNS Spectrums , Volume 18 , Issue 2 , April 2013 , pp. 103 - 111
Copyright
Copyright © Cambridge University Press 2013

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Footnotes

Funding for this study was provided by the National Institute of Mental Health (R34 MH73014) and the Ohio Board of Regents.

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