Utility of the injured trauma survivor screen to predict PTSD and depression during hospital admission

J Trauma Acute Care Surg. 2017 Jan;82(1):93-101. doi: 10.1097/TA.0000000000001306.

Abstract

Background: The brief, easily administered screen, the Injured Trauma Survivor Screen (ITSS), was created to identify trauma survivors at risk for development of posttraumatic stress disorder (PTSD) and depression.

Methods: An item pool of PTSD risk factors was created and given, along with a previously created screen, to patients admitted to two Level 1 trauma centers. The Clinician Administered PTSD Scale for DSM-5, the PTSD Checklist for DSM-5, and the Center for Epidemiological Studies Depression Scale Revised were given during a 1-month follow-up. A total of 139 participants were included (n = 139; μ age = 41.06; 30.9% female; 47.5% White/Caucasian; 39.6% Black/African American; 10.1% Latino/Hispanic; 1.4% American Indian; and 1.4% other). Stepwise bivariate logistic regression was used to determine items most strongly associated with PTSD and depression diagnosis 1 month after injury.

Results: Forty participants met criteria for a PTSD diagnosis and 28 for depression at follow-up (22 comorbid). ROC curve analysis was used to determine sensitivity (PTSD = 75.00, Depression = 75.00), specificity (PTSD = 93.94, Depression = 95.5), NPV (PTSD = 90.3, Depression = 80.8), and PPV (PTSD = 83.3, Depression = 93.8) of the final nine-item measure.

Conclusions: This study provides evidence for the utility of a predictive screen, the ITSS, to predict which injured trauma survivors admitted to the hospital are at the most risk for developing symptoms of PTSD and depression 1 month after injury. The ITSS is a short, easily administered tool that can aid in reducing the untreated cases of PTSD and depression.

Level of evidence: Prognostic study, level III.

MeSH terms

  • Adult
  • Depression / diagnosis*
  • Depression / etiology*
  • Depression / psychology
  • Female
  • Glasgow Coma Scale
  • Hospitalization
  • Humans
  • Male
  • Mass Screening / methods*
  • Psychiatric Status Rating Scales
  • Risk Factors
  • Sensitivity and Specificity
  • Stress Disorders, Post-Traumatic / diagnosis*
  • Stress Disorders, Post-Traumatic / etiology*
  • Stress Disorders, Post-Traumatic / psychology
  • Survivors / psychology*
  • Wounds and Injuries / complications*
  • Wounds and Injuries / psychology