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

Abstract

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 relevan tliteratureoriginatesin only a few countries, and much remains unknown abo ut MVC-related PTSD prevalence and predictors. Methods: Data come from the World Mental Health Survey In itiative, a coordinated series of community epidemiological surveys of mental disorders throu ghout the world. The subset of 13 surveys (5 in high income countries, 8 in middle or low income countr ies) with respondents reporting PTSD after life- threatening MVCs are considered here. Six classes o f predictors were assessed: socio-demographics, characteristics of the MVC, childhood family adversities, MVCs, other traumatic experiences, and respondent history of prior mental disorders. Logistic regre ssion was used to examine predictors of PTSD. Mental disorders were assessed with the fully-structured Compos ite International Diagnostic Interview using DSM-IV criteria. Results: Prevalence of PTSD associated with MVCs percei ved 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