Course From Initial Trauma Response to PTSD Shows Considerable Variation, Study Finds

The way from trauma to delayed-onset posttraumatic stress disorder (PTSD)may be long and winding, according to Australian researchers. They evaluated 1,084 patients admitted to four trauma hospital units and then assessed them again at three, 12, and 24 months after their injuries. The course of illness and risk among these patients was complex, wrote Richard Bryant, Ph.D., Alexander MacFarlane, M.D., and colleagues in JAMA Psychiatry online yesterday.

Among those diagnosed with PTSD at 24 months, 44 percent reported no PTSD at three months. Initial PTSD symptom severity in that group predicted PTSD severity at 24 months, as did the presence of mild traumatic brain injury, the length of hospital stay, and experiencing stressful events between three and 24 months. Among the other 56 percent of patients with diagnosed PTSD or symptoms of the disorder at three months, having had a prior psychiatric disorder, severity of initial PTSD symptom, and type of injury predicted PTSD severity at 24 months.

"The present study demonstrates longitudinally that there is not a linear relationship between acute trauma response and long-term PTSD and highlights that PTSD levels fluctuate markedly in the initial years after trauma exposure,” concluded the authors. “This pattern can explain the modest predictive capacity of acute markers to identify subsequent PTSD status.”

For more in Psychiatric News about trauma and PTSD, click here. Also see the Journal of Neuropsychiatry and Clinical Neurosciences here.

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