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Psychiatric Morbidity After Motor Vehicle Accidents

People who experience motor vehicle accidents often have psychiatric sequelae. These investigators studied the frequency of 4 psychiatric outcomes in a cohort of 1441 consecutive patients assessed in an emergency department after motor vehicle accidents.

Patients completed self-report questionnaires and mailed follow-up questionnaires at 3 months and 1 year. A third of respondents reported that they had psychiatric disorders: phobic travel anxiety (22 percent and 16 percent at 3 months and 1 year, respectively), general anxiety (17 percent and 19 percent), depression (5 percent and 6 percent), or posttraumatic stress disorder (23 percent and 17 percent). Significant overlap between PTSD, generalized anxiety, and phobic travel disorder was found. For each disorder, 5 percent of patients reported delayed onset between 3 months and 1 year after the accident. Predictors differed by psychiatric diagnosis and included previous emotional, social, or financial problems (or a combination of these); being a passenger rather than driver; previous low levels of confidence as a passenger; female gender; high baseline levels of negative emotions or tendencies to dissociate; and persistent health problems. Motorcyclists were 8 times more likely to suffer phobic travel anxiety than men in other types of accidents.

Comment: These results show the frequency of psychiatric morbidity following motor vehicle accidents and the complexity of contributing factors. Regarding the findings for motorcyclists, this research group previously reported that 42 percent of motorcyclists had given up their motorcycles 1 year after involvement in an accident. Awareness of the high risk for psychiatric outcomes after these accidents suggests the need for more systematic screening for risk factors and earlier intervention to deter development of symptoms.

— J Yager

Published in Journal Watch Psychiatry August 22, 2001

Citation(s):

Mayou R et al. Prediction of psychological outcomes one year after a motor vehicle accident. Am J Psychiatry 2001 Aug 158 1231-1238.

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