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Events surrounding a serious injury affect the likelihood that an adolescent will suffer from long-term post traumatic stress disorder

Like adults, over one-fourth (27 percent) of adolescents suffer from long-term post traumatic distress disorder (PTSD) after a serious injury, according to a study supported in part by the Agency for Healthcare Research and Quality (HS07611). The events surrounding injuries such as motor vehicle accidents, falls, or assaults, affect the likelihood that an adolescent will develop PTSD, explains Troy L. Holbrook, Ph.D., of the University of California, San Diego.

Dr. Holbrook and a team of researchers collected information from adolescent trauma patients ages 12 to 19 years, including patient demographics and injury event characteristics. They conducted several surveys to measure the adolescents' functional status before and after an injury as well as early symptoms of acute stress disorder at discharge. Outcomes were assessed at hospital discharge and at 3, 6, 12, 18, and 24 months after discharge, and post-injury behavioral problems, evaluated at a 6-month followup.

The results indicate that perceived threat to life and intentional or violence-related injury doubled the likelihood of PTSD onset, as did having no control over the event leading to the injury. Death of a family member at the scene increased nearly five-fold the odds of suffering from PTSD.

Girls and older adolescents had higher rates of PTSD than boys and younger adolescents. Low socioeconomic status was strongly associated with long-term PTSD. Adolescents who suffered from PTSD were more likely to have behavioral problems, abuse alcohol and drugs, have difficulty staying in school, and suffer from depression.

More details are in "Long-term posttraumatic stress disorder persists after major trauma in adolescents: New data on risk factors and functional outcome," by Dr. Holbrook, David B. Hoyt, M.D., F.A.C.S., Raul Coimbra, M.D., F.A.C.S., and others, in the April 2005 Journal of Trauma, Injury, Infection, and Critical Care 58, pp. 764-771.

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