Shanthi Ameratunga, Counties Manukau Health, Auckland, NZ
Shanthi Ameratunga is a paediatrician and public health physician, a Senior Researcher at Counties Manukau Health (Population Health Directorate and Kidz First Hospital) and an Honorary Professor at the University of Auckland. She has research expertise in injury prevention, trauma outcomes, disability, youth health, and interventions addressing health inequities.
Prevalence and Predictors of Post-Traumatic Stress Disorder in a Cohort of 2200 Injured New Zealanders
Ameratunga, S., Counties Manukau DHB, South Auckland, NZ
Samaranayaka, A., University of Otago, Dunedin, NZ, Wyeth, E., University of Otago, Dunedin, NZ; Davie, G., University of Otago, Dunedin, NZ; Lilley, R., University of Otago, Dunedin, NZ; Wilson, S., University of Otago, Dunedin, NZ; Kokaua, J., University of Otago, Dunedin, NZ;
Derrett, S., University of Otago, Dunedin, NZ
Introduction: Post-traumatic stress disorder (PTSD) following injuries unrelated to mass casualty events has drawn scant research attention in New Zealand. Internationally, most studies investigating predictors of post-injury PTSD focus on hospitalised patients although most survivors are not hospitalised. We hypothesise that PTSD imposes a significant burden on injured people regardless of whether their injury required hospitalisation.
Aim: To compare the prevalence and predictors of PTSD 12-months following injury among hospitalised and non-hospitalised entitlement claimants registered with the Accident Compensation Corporation (ACC), the government-funded no-fault injury insurance scheme.
Methods: A cohort of 2220 ACC claimants aged 18-64 years recruited to the Prospective Outcomes of Injury Study were interviewed 12 months post-injury to identify symptoms suggestive of PTSD using the Impact of Events Scale. Multivariable models investigated relationships between the risk of PTSD among hospitalised and non-hospitalised groups and baseline covariates including pre-injury health, substance use, injury perceptions and health service interactions.
Results: PTSD symptoms were reported by 17% of hospitalised and 12% of non-hospitalised participants. Perceived threat to life at the time of the injury doubled the PTSD risk among hospitalised (adjusted Relative Risk (RR) 2.0; 95%CI: 1.2 to 3.2) and non-hospitalised (RR 1.8; 95%CI: 1.2 to 2.8) participants. Among hospitalised participants, predictors of PTSD also included female sex, Pacific ethnicity, “other ethnicities”, pre-injury depressive symptoms, financial insecurity, and perceptions of inadequate information or insufficient time to discuss problems. Among non-hospitalised survivors, smoking, hazardous drinking, assault, and poor expectations of recovery were identified as predictors of PTSD.
Conclusions: At 12 months post-injury, PTSD symptoms were experienced by one in six hospitalised and one in eight non-hospitalised people. Perceived threat to life was a strong predictor in both groups. Identifying early predictors of PTSD in hospitalised and non-hospitalised injury survivors could assist the implementation of tailored interventions that reduce longer-term psychosocial morbidity.