John Walsh Centre for Rehabilitation Research, Sydney Medical School-Northern, The University of Sydney, Kolling Institute of Medical Research, St Leonards, NSW, Australia.
Sydney Medical School-Northern, Kolling Institute of Medical Research, The University of Sydney, Royal North Shore Hospital, Corner Reserve Road & Westbourne Street, St Leonards, NSW, 2065, Australia.
BMC Psychol. 2018 Feb 21;6(1):4. doi: 10.1186/s40359-018-0216-5.
Physical injury and psychological disorder following a motor vehicle crash (MVC) is a public health concern. The objective of this research was to determine rates of major depressive disorder (MDD) and post-traumatic stress disorder (PTSD) in adults with MVC-related injury engaged in compensation, and to determine the capacity (e.g. sensitivity and specificity) of two psychometric scales for estimating the presence of MDD and PTSD.
Participants included 109 adults with MVC-related injury engaged in compensation during 2015 to 2017, in Sydney, Australia. The mean time from MVC to baseline assessment was 11 weeks. Comprehensive assessment was conducted at baseline, and the Depression Anxiety Stress Scales (DASS-21) and the Impact of Event Scale-Revised (IES-R) were administered to determine probable MDD and PTSD. An online psychiatric interview, based on Diagnostic and Statistical Manual for Mental Disorders (DSM-5), was used to diagnose actual MDD and PTSD, acknowledged as gold standard diagnostic criteria. One-way multivariate analyses of variance established criterion validity of the DASS-21 and IES-R, and sensitivity and specificity analyses were conducted to determine the most sensitive cut-off points for detecting probable MDD and PTSD.
Substantial rates of MDD (53.2%) and PTSD (19.3%) were found. The DASS-21 and IES-R were shown to have excellent criterion validity for detecting MDD and PTSD in injured participants. A range of cut-off points were investigated and shown to have acceptable sensitivity and specificity for detecting MDD and PTSD in an injured population engaged in compensation. The preferred cut-off points based on this study are: to detect MDD, a DASS-21 total score of 30 and/or a DASS-21 depression score of 10; to detect PTSD, IES-R scores of 33-40 and/or a DASS-21 anxiety score of 7-8.
Major psychological disorder is prevalent following a MVC. Results suggest the DASS-21 and IES-R are suitable for use in clinical/compensation settings to detect probable MDD and PTSD soon after a MVC in physically injured people engaged in compensation. These results provide positive direction in the public health arena for improving mental health outcomes.
Clinical Trials registration number: ANZCTR - ACTRN12615000326594 (9th April 2015).
机动车事故（MVC）后身体损伤和心理障碍是一个公共健康问题。本研究的目的是确定参与赔偿的 MVC 相关损伤成年人中重度抑郁症（MDD）和创伤后应激障碍（PTSD）的发生率，并确定两种心理计量学量表估计 MDD 和 PTSD 存在的能力（例如敏感性和特异性）。
参与者包括 2015 年至 2017 年期间在澳大利亚悉尼参与赔偿的 109 名 MVC 相关损伤成年人。从 MVC 到基线评估的平均时间为 11 周。在基线时进行全面评估，并使用抑郁焦虑应激量表（DASS-21）和修订后的事件影响量表（IES-R）来确定可能的 MDD 和 PTSD。基于精神疾病诊断与统计手册（DSM-5）的在线精神病学访谈用于诊断实际的 MDD 和 PTSD，这被认为是金标准诊断标准。单变量方差分析建立了 DASS-21 和 IES-R 的效标效度，进行了敏感性和特异性分析，以确定检测可能的 MDD 和 PTSD 的最敏感截断点。
发现大量的 MDD（53.2%）和 PTSD（19.3%）。结果表明，DASS-21 和 IES-R 对于检测受伤参与者的 MDD 和 PTSD 具有极好的效标效度。研究调查了一系列截断点，并显示在参与赔偿的受伤人群中检测 MDD 和 PTSD 具有可接受的敏感性和特异性。基于本研究的首选截断点是：检测 MDD，DASS-21 总分 30 分和/或 DASS-21 抑郁得分 10 分；检测 PTSD，IES-R 得分 33-40 分和/或 DASS-21 焦虑得分 7-8 分。
MVC 后主要心理障碍普遍存在。结果表明，DASS-21 和 IES-R 适合在临床/赔偿环境中使用，以检测参与赔偿的身体受伤人员在 MVC 后不久可能出现的 MDD 和 PTSD。这些结果为改善公共卫生领域的心理健康结果提供了积极的方向。
临床试验注册号：ANZCTR - ACTRN12615000326594（2015 年 4 月 9 日）。
