Please use this identifier to cite or link to this item: http://hdl.handle.net/2440/80752
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Type: Journal article
Title: Exploration of delayed-onset posttraumatic stress disorder after severe injury
Author: O'Donnell, M.
Varker, T.
Creamer, M.
Fletcher, S.
McFarlane, A.
Silove, D.
Bryant, R.
Forbes, D.
Citation: Psychosomatic Medicine, 2013; 75(1):68-75
Publisher: Lippincott Williams & Wilkins
Issue Date: 2013
ISSN: 0033-3174
1534-7796
Statement of
Responsibility: 
Meaghan L. O’Donnell, Tracey Varker, Mark Creamer, Susan Fletcher, Alexander C. McFarlane, Derrick Silove, Richard A. Bryant, David Forbes
Abstract: OBJECTIVE The first aim of this work was to conduct a rigorous longitudinal study to identify rates of delayed-onset posttraumatic stress disorder (PTSD) in a sample of patients with severe injury. The second aim was to determine what variables differentiated delayed-onset PTSD from chronic PTSD. METHODS Randomly selected patients with injury who were admitted to four hospitals around Australia were recruited to the study (N = 834) and assessed in the acute care hospital, at 3 months, and at 12 months. A structured clinical interview was used to assess PTSD at each time point. RESULTS Seventy-three patients (9%; n = 73) had PTSD at 12 months. Of these, 39 (53%) were classified as having delayed-onset PTSD. Furthermore, 22 (56%) patients with delayed-onset PTSD had minimal PTSD symptoms at 3 months (i.e., they did not have partial/subsyndromal PTSD at 3 months). The variables that differentiated delayed-onset PTSD from chronic PTSD were greater injury severity (odds ratio [OR] = 1.13; 95% confidence interval [CI] = 1.02–1.26), lower anxiety severity at 3 months (OR = 0.73; 95% CI = 0.61–0.87), and greater pain severity at 3 months (OR = 1.39; 95% CI = 1.06–1.84). CONCLUSIONS Delayed-onset PTSD occurred frequently in this sample. Approximately half of the patients with delayed-onset PTSD had minimal PTSD symptoms at 3 months; therefore, their delayed-onset PTSD could not be accounted for by a small number of fluctuating symptoms. As we move toward DSM-V, it is important that research continues to explore the factors that underpin the development of delayed-onset PTSD.
Keywords: delayed onset; posttraumatic stress disorder; subsyndromal PTSD; partial PTSD; prediction
Rights: Copyright © 2013 by the American Psychosomatic Society
RMID: 0020124648
DOI: 10.1097/PSY.0b013e3182761e8b
Grant ID: http://purl.org/au-research/grants/nhmrc/568970
Published version: http://www.psychosomaticmedicine.org/content/75/1/68
Appears in Collections:Medicine publications

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