Hostname: page-component-78c5997874-dh8gc Total loading time: 0 Render date: 2024-11-13T00:50:52.188Z Has data issue: false hasContentIssue false

The Long-Term Psychiatric Consequences of Accidental Injury

A Longitudinal Study of 107 Adults

Published online by Cambridge University Press:  02 January 2018

Ulrik Malt*
Affiliation:
University of Oslo; The National Hospital, N-0027 Oslo 1, Norway

Abstract

One hundred and seven accidentally injured adults were studied while in hospital and assessed prospectively twice more in a mean period of 28 months. The patients were studied by means of taped clinical interviews, including the Comprehensive Psycho-pathological Rating Scale (which includes the Montgomery-åsberg Depression Rating Scale), and several self-report measures of distress (Schedule of Recent Life Events, General Health Questionnaire, Impact of Event Scale and State Anxiety Inventory) at the three assessments. The total incidence of psychiatric disorders considered to be caused by the accident during the follow-up period was 22.4%. The incidence of non-organic psychiatric disorders caused by the accident was 16.8% at the first follow-up and 9.3% at the final follow-up. Depressive disorders of different severity were most often seen. Only one patient suffered from a posttraumatic stress disorder during the follow-up, and none at the final follow-up (DSM-III). Organic mental disorders were diagnosed in 9.3% of the patients. In 5.6% of the patients this was the only disorder.

Type
Research Article
Copyright
Copyright © Royal College of Psychiatrists, 1988 

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

American Psychiatric Association (1980) Diagnostic and Statistical Manual of Mental Disorders (3rd edn) (DSM-III). Washington DC: American Psychiatric Association Press.Google Scholar
Åsberg, M., Perris, C, Schalling, D. & Sedvall, G. (1978) The CPRS: development and applications of a psychiatric rating scale. Acta Psychiatrica Scandinavica, 60, suppl. 271.Google Scholar
Brown, G. W. & Harris, T. (1978) Social Origins of Depression. New York: The Free Press.Google Scholar
Brown, J. T. (1986) Grief response in trauma patients and their families. Advances in Psychosomatic Medicine, 16, 93114.Google Scholar
Eitinger, L. & Strom, A. (1981) Investigations on the mortality and morbidity of Norwegian ex-concentration camp prisoners. Israel Journal of Psychiatry and Related Sciences, 18, 173195.Google Scholar
Gleser, G. C., Green, B. L. & Winget, C. (1981). Prolonged Psychosocial Effects of Disaster: a Study of Buffalo Creek. New York: Academic Press.Google Scholar
Goldberg, D. (1978) Manual of the General Health Questionnaire. Windsor: NFER Publishing Company.Google Scholar
Greenspan, L., McLellan, B. A. & Greig, H. (1985) Abbreviated injury scale and injury severity score: a scoring chart. Journal of Trauma, 25, 6064.CrossRefGoogle ScholarPubMed
Grove, W. M., Andreasen, N. C., McDonald-Scott, P., Keller, M. B. & Shapiro, R. W. (1981) Reliability studies of psychiatric diagnosis. Archives of General Psychiatry, 38, 408413.CrossRefGoogle ScholarPubMed
Grove, W. M., Grove, W.A. & Andreasen, N. C. (1982) Simultaneous tests of many hypotheses in explanatory research. Journal of Nervous and Mental Disease, 170, 38.CrossRefGoogle Scholar
Hoffmann, B. F. (1986) How to write a psychiatric report for litigation following a personal injury. American Journal of Psychiatry, 143, 164169.Google Scholar
Holmes, T. H. & Rahe, R. H. (1967) The social readjustment rating scale. Journal of Psychosomatic Research, 11, 213218.Google Scholar
Horowitz, M. J. (1976) Stress Response Syndromes. New York: Jason Aronson.Google Scholar
Horowitz, M. J. (1982) Stress response syndromes and their treatment. In Handbook of Stress: Theoretical and Clinical Aspects (eds Goldberger, L. & Breznitz, S.). New York: The Free Press.Google Scholar
Ischii, T. (1983) A comparison of cerebral atrophy in CT scan findings among alcoholic groups. Acta Psychiatrica Scandinavica, 68, suppl. 309.Google Scholar
Kessler, L. G., Cleary, P. D. & Burke, J. D. (1985) Psychiatric disorders in primary care. Archives of General Psychiatry, 42, 583587.Google Scholar
Lishman, W. A. (1978) Organic Psychiatry. Oxford: Blackwell.Google Scholar
Livingston, M. G. (1987) Head injury: the relatives' response. Brain Injury, 1, 3339.Google Scholar
Lloyd, G. G. & Cawley, R. H. (1983) Distress or illness? A study of psychological symptoms after myocardial infarction. British Journal of Psychiatry, 142, 120125.Google Scholar
Maguire, G. P., Lee, E. G., Bevington, D. J., Kuchemann, C. S., Crabtree, R. J. & Cornell, C. E. (1978) Psychiatric problems in the first year after mastectomy. British Medical Journal, i, 963965.CrossRefGoogle Scholar
Maier, C. (1984) Korrelation von computertomographischen Befunden und testpsychologischen Ergebnissen bei Patienten mit Schaedel-Hirn-Traumen. Fortschritte der Neurologie und Psychiatric 52, 346351.Google Scholar
Malt, U. (1980) Longterm follow-up studies of burned adults: review of the literature. Journal of Burns, 6, 190197.Google Scholar
Malt, U. (1986) Five years experience with the DSM-III system in clinical work and research: some concluding remarks. Acta Psychiatrica Scandinavica, 73, Suppl. 328, 7684.Google Scholar
Malt, U., Myhrer, T., Blikra, G. & Hoivik, B. (1987) Psychopathology and accidental injuries. Acta Psychiatrica Scandinavica, 76, 261271.Google Scholar
Mayou, R. (1984) Prediction of emotional and social outcome after a heart attack. Journal of Psychosomatic Research, 28, 1725.CrossRefGoogle ScholarPubMed
Malt, U., Williamson, B. & Foster, A. (1978) Outcome two months after myocardial infarction. Journal of Psychsomatic Research, 22, 439445.Google Scholar
McFarlane, A. C. (1986) Posttraumatic morbidity of a disaster: a study of cases presenting for psychiatric treatment. Journal of Nervous and Mental Disease, 174, 414.CrossRefGoogle ScholarPubMed
Mendelson, G. (1984) Follow-up studies of personal injury litigants. International Journal of Law and Psychiatry, 7, 179188.Google Scholar
Montgomery, S. A. & Åsberg, M. (1979) A new depression scale designed to be sensitive to change. British Journal of Psychiatry, 134, 382389.CrossRefGoogle ScholarPubMed
Paykel, E. S. (1983) Methodological aspects of life event research. Journal of Psychosomatic Research, 27, 341352.Google Scholar
Raphael, B. (1986) When Disaster Strikes. London: Hutchinson. Ron, M. A., Acker, W. & Lishman, W. A. (1980) Morphological abnormalities in the brains of chronic alcoholics: a clinical, psychological and computerized axial tomography study. Acta Psychiatrica Scandinavica, 62, suppl. 286, 5156.Google Scholar
Silverman, J. J. (1986) Posttraumatic stress disorder. Advances in Psychosomatic Medicine, 16, 115140.CrossRefGoogle Scholar
Snaith, R. P., Harrop, F. M., Newby, D. A. & Teale, C. (1986) Grade scores of the Montgomery-Åsberg Depression and the Clinical Anxiety Scales. British Journal of Psychiatry, 148, 599601.CrossRefGoogle ScholarPubMed
Spielberger, C. D., Gorsuch, R. L. & Lushhene, R. E. (1970) Manual of the State Trait Anxiety Inventory. Palo Alto: Consulting Psychologists Press.Google Scholar
Stern, M. I., Pascale, L. & McLoone, J. B. (1976) Psychosocial adaptation following an acute myocardial infarction. Journal of Chronic Diseases, 29, 513526.Google Scholar
Tarsh, M. J. & Royston, C. (1985) A follow-up study of accident neurosis. British Journal of Psychiatry, 146, 1825.CrossRefGoogle ScholarPubMed
Thomas, C, Madden, F. & Jehu, D. (1984) Psychosocial morbidity in the first three months following stoma surgery. Journal of Psychosomatic Research, 28, 251257.Google Scholar
Thorson, J. (1975) The Longterm Effects of Traffic Accidents. Lund: Håkan Ohlsons.Google Scholar
Tousignant, M., Brosseau, R. & Tremblay, L. (1987) Sex biases in mental health scales: do women tend to report less serious symptoms and confide more than men? Psychological Medicine, 17, 203215.Google Scholar
Trimble, M. (1981) Posttraumatic Neurosis. New York: Wiley.Google Scholar
Watson, I. P. B., Hoffmann, L. & Wilson, G. V. (1988) The neuropsychiatry of posttraumatic stress disorder. British Journal of Psychiatry, 152, 164173.CrossRefGoogle Scholar
Weisæth, L. (1985) Posttraumatic stress disorder after an industrial disaster. In Psychiatry: the State of the Art, Vol. 6 (eds Pichot, P., Berner, P., Wolf, R. & Thau, K.). New York: Plenum Press.Google Scholar
Weiss, D. S., Horowitz, M. J. & Wilner, N. (1984) The stress response rating scale: a clinician's measure for rating the response to serious life events. British Journal of Clinical Psychology, 23, 202215.Google Scholar
White, A. C. (1982) Psychiatric study of patients with severe burn injuries. British Medical Journal, 284, 465467.CrossRefGoogle ScholarPubMed
World Health Organization (1977) International Classification of Diseases, 1975 revision. Geneva: WHO.Google Scholar
Submit a response

eLetters

No eLetters have been published for this article.