Fekadu Wubalem, Mekonen Tesfa, Belete Habte, Belete Amsalu, Yohannes Kalkidan
Psychiatry Department, School of Medicine, College of Medicine and Health Sciences, Bahir Dar University, Bahir Dar, Ethiopia.
Psychiatry Department, School of Medicine, College of Health Sciences, Addis Ababa University, Addis Ababa, Ethiopia.
Front Psychiatry. 2019 Jul 19;10:519. doi: 10.3389/fpsyt.2019.00519. eCollection 2019.
Post-traumatic stress disorder (PTSD) occurs after exposure to actual or threatened death, serious injury, or sexual violence. Road traffic accident (RTA) is one of the traumatic experiences, which may result in PTSD. But treatment is mainly concentrated on physical health. This may be due to a lack of evidence in low-income countries. To determine the incidence level and identify risk factors of PTSD after RTA. Longitudinal panel study was done to assess the incidence of PTSD after RTA. The study was conducted in three orthopedic settings of Bahir Dar town Northwest, Ethiopia. The study was on 299 adult car accident survivors. PTSD Checklist (PCL) civilian version, Sheehan disability assessment scale, Patient Health Question (PHQ-2), and Alcohol Use Disorder Identification Test (AUDIT) were instruments to assess the outcome and associated factors. The generalized linear model with Poisson log-linear method was applied to identify associated factors. Ethical clearance was obtained from Bahir Dar University. Individuals with PTSD symptoms were linked to the psychiatric clinic. One hundred thirty-nine (46.5%) participants had at least three extremely severe symptoms that fulfil criteria B, C, and D of Diagnostic Statistical Manual IV of PTSD. The most frequent severe symptoms were having repeated, disturbing memories, thoughts, or images. Two hundred ten (70.2%) participants reported the extreme impact of the accident on work or schooling and 156 (51.9%) reported extreme problems in social functioning. Alcohol dependence, hazardous alcohol consumption, and harmful use were reported by 7.9%, 15.1%, and 4.7% of the participants, respectively. In the final model witnessing death, severe sleep problem and severe impairment in family functioning were significantly associated with PTSD. Nearly half of RTA survivors develop PTSD. Clinicians need to link these patients to the psychiatry clinic. Special attention should be given to patients who witnessed death, with a serious disability, and previous psychiatric history.
创伤后应激障碍（PTSD）发生在经历实际的或受到威胁的死亡、严重伤害或性暴力之后。道路交通事故（RTA）是可能导致PTSD的创伤经历之一。但治疗主要集中在身体健康方面。这可能是由于低收入国家缺乏相关证据。为了确定道路交通事故后PTSD的发病率水平并识别风险因素，开展了纵向队列研究以评估道路交通事故后PTSD的发病率。该研究在埃塞俄比亚西北部巴赫达尔镇的三个骨科医疗机构进行。研究对象为299名成年车祸幸存者。创伤后应激障碍检查表（PCL）民用版、希恩残疾评估量表、患者健康问卷（PHQ - 2）和酒精使用障碍识别测试（AUDIT）是用于评估结果及相关因素的工具。采用泊松对数线性方法的广义线性模型来识别相关因素。获得了巴赫达尔大学的伦理批准。有PTSD症状的个体被转介到精神科诊所。139名（46.5%）参与者至少有三种极其严重的症状，符合PTSD诊断统计手册第四版的B、C和D标准。最常见的严重症状是反复出现令人不安的记忆、想法或图像。210名（70.2%）参与者报告事故对工作或学业有极大影响，156名（51.9%）报告社交功能存在极大问题。分别有7.9%、15.1%和4.7%的参与者报告有酒精依赖、危险饮酒和有害饮酒情况。在最终模型中，目睹死亡、严重睡眠问题和家庭功能严重受损与PTSD显著相关。近一半的道路交通事故幸存者会患上PTSD。临床医生需要将这些患者转介到精神科诊所。对于目睹死亡、有严重残疾和有既往精神病史的患者应给予特别关注。
