A systematic review and meta-analysis of the prevalence of post-traumatic stress disorder (PTSD) in road traffic accident survivors

Background: Post-traumatic stress disorder (PTSD) among road traffic accident (RTA) survivors, gets received little attention as medical experts prioritize treating physical injuries. In Pakistan, PTSD remains understudied. Therefore, this study aimed to determine the prevalence and predictors of PTSD. Methods: This cross-sectional study was performed among 128 survivors of RTA at Benazir Bhutto hospital, Rawalpindi. Data were collected via a pre-tested PTSD checklist-specific version (PCL-S) tool to screen for PTSD and a self-designed proforma. Descriptive and inferential statistics were used in the data analysis using the statistical package for the social sciences (SPSS) version 25. The p<0.05 was used set a significant. Results: The 34 (26.56%) participants of study population had PTSD. Following adjustment for potential confounding variables, the following factors were found to be significant predictors of PTSD: time since RTA (1-3 months) (AOR=0.38; 95% CI (0.18, 0.76), history of prior RTA (AOR=2.56; 95% CI (1.22, 5.47), presence of close one in the same RTA, (AOR=2.23, 95% CI (1.14, 4.46), witnessing of death of close one in the same RTA, (AOR=7.49, 95% CI (3.16, 14.68) and previous history of psychiatric illness (AOR=12.35, 95% CI (5.32, 28.29). Conclusions: Our study population had significant prevalence of PTSD (26.56%). Significant predictors of PTSD included the amount of time after the accident, the history of prior traffic accidents, presence of close one in same accident, witnessing the death of close one in same accident, and history of psychiatry disorder.

Road traffic accidents are a major public health concern globally and in Nepal, leading not only to significant physical injuries but also to psychological consequences such as post-traumatic stress disorder. Despite the high incidence of road traffic accidents in Kathmandu Valley, there is limited research on the prevalence of Post-Traumatic Stress Disorder (PTSD) and its associated factors among survivors in this setting. This study aimed to determine the prevalence of post-traumatic stress disorder and identify its associated factors among road traffic accident survivors in Kathmandu Valley, Nepal. A descriptive cross-sectional study was conducted among 183 road traffic accident survivors attending two hospitals and selected physiotherapy centers in Kathmandu Valley from September to November 2021. Participants were at least one month post-accident and were recruited using convenience sampling. Data were collected through face-to-face interviews using a structured questionnaire, which included the PTSD Checklist for DSM-5. A score of 33 or higher indicated probable PTSD. Descriptive statistics summarized participant characteristics. Bivariate and multivariate logistic regression analyses were performed to identify factors associated with post-traumatic stress disorder, with adjusted odds ratios and 95% confidence intervals reported. Among the 183 participants, 26.8% met the criteria for probable PTSD. Higher odds of PTSD were observed among survivors aged 53 years and above, females, and those involved in truck-related accidents. Lower educational attainment was also associated with increased risk. Most participants were male (76.5%), with most accidents involving bikes/scooters (85.8%). Multivariate analysis showed that participants aged 53 years and above (AOR: 3.78; 95% CI: 1.00-14.17) and those involved in truck-related accidents (AOR: 7.61; 95% CI: 1.12-51.38) had significantly higher odds of developing PTSD symptoms. . The prevalence of post-traumatic stress disorder among road traffic accident survivors in Kathmandu Valley is substantial. Older age, female gender, and involvement in truck-related accidents are significant risk factors. These findings highlight the need to integrate routine mental health screening and targeted interventions into trauma care services for road traffic accident survivors, particularly for vulnerable groups. Further longitudinal research is recommended to understand the progression of post-traumatic stress disorder better and inform effective intervention strategies in Nepal.

Background: Post traumatic stress disorder (PTSD) is the most common mental disorder occurring among survivors of road traffic accidents (RTA). It could result in long-term adverse consequences if left untreated, mainly leading to social and functional impairments of RTA survivors, which finally results in a poor quality of life. Objectives: To assess the prevalence of PTSD among the RTA survivors and the associated factors of it. Materials & methods: An institution-based cross-sectional study was carried out among 202 admitted RTA patients in the inpatient department of a specialized hospital in Dhaka city for one year duration. Data were collected from these patients using a semi structured interview administered questionnaire where the Diagnostic and Statistical Manual-IV DSM-IV(PCL-S) checklist used to assess PTSD. The collected data were analyzed by using SPSS software (Version 21) and p < 0.05 considered as significant. Results: A total 202 RTA patients were included in the study and the prevalence of probable PTSD among RTA survivors was 41.1% according to DSM-IV(PCL-S) checklist. The mean age of RTA survivors found 37.6 (±13.2) years, majority 57.4% belongs to 18-30 years age group. The mean PTSD score found was 44.1(±8.2), 9.2% RTA survivors had previous history of known depressive symptoms. Among the socio-demographic attributes, age and occupation were significantly associated with the PTSD; other accident related factors like time since accident and type of accident were strongly associated with the PTSD. Conclusion: This study found a high prevalence of PTSD among RTA survivors with some associated significant sociodemographic and accident-related factors. The findings suggest a need for early screening for PTSD among the survivors of RTA. Update Dent. Coll. j: 2022; 12(2): 14-18

ABSTRACTBackground: Alterations in brain-derived neurotrophic factor (BDNF) expression and release may play a role in the pathogenesis of post-traumatic stress disorder (PTSD). Design: This study evaluated road traffic accident (RTA) survivors to determine whether PTSD and trauma-related factors were associated with plasma BDNF levels and BDNF Val66Met carrier status following RTA exposure. Methods: One hundred and twenty-three RTA survivors (mean age 33.2 years, SD = 10.6 years; 56.9% male) were assessed 10 (SD = 4.9) days after RTA exposure. Acute stress disorder (ASD), as assessed with the Acute Stress Disorder Scale, was present in 50 (42.0%) of the participants. Plasma BDNF levels were measured with enzyme-linked immunosorbent assay and BDNF Val66Met genotyping was performed. PTSD, as assessed with the Clinician-Administered PTSD Scale, was present in 10 (10.8%) participants at 6 months follow-up. Results: Neither BDNF Val66Met genotype nor plasma BDNF was significantly associated with the presence or severity of ASD or PTSD. Plasma BDNF levels were, however, significantly correlated with the lifetime number of trauma exposures. Conclusions: In RTA survivors, plasma BDNF levels increased with increasing number of prior trauma exposures. Plasma BDNF may, therefore, be a marker of trauma load.

BackgroundPost-traumatic stress disorder is the most common mental disorders occurring among survivors of road traffic accident. However, research into post-traumatic stress disorder and correlates in low and middle-income countries is limited. To the best of our knowledge, there is no published study of the post-traumatic stress disorder and associated factors conducted in Ethiopia. Therefore, this study aimed to determine the prevalence of post-traumatic stress disorder and associated factors among survivors of road traffic accident.MethodsInstitution based cross-sectional study was conducted in May 2016. Data were collected using a pretested, structured, standardized post-traumatic stress disorder Checklist-Specific version (PCL-S) questionnaire. Systematic sampling technique was used to select the study participants. Binary logistic regression analysis was used to identify associated factors. Odds ratio with 95% CI was computed to assess the strength of associations.ResultsThe prevalence of post-traumatic stress disorder was found to be 22.8% (CI 19.2, 26.6) among survivors of road traffic accident. In the multivariable analysis, Being female [AOR = 2.23, 95% CI 1.40, 3.56], having poor social support [AOR = 2.1, 95% CI 1.34, 3.46], duration since accident (1–3 months) [AOR = 1.72, 95% CI 1.07, 2.76] and having depression [AOR = 3.46, 95% CI 1.99, 5.99] were significantly associated with PTSD among survivors of road traffic accident.ConclusionIn the current study the magnitude of post-traumatic stress disorder was high. Being female, poor social support, duration since the accident (1–3 months) and depression were found to be significant predictors of post-traumatic stress disorders. The finding suggests a need for early screening for post-traumatic disorder among survivors of road traffic accidents.

BackgroundPost-traumatic stress disorder is the most common mental disorder occurring among survivors of road traffic accidents. However, it remains under-explored and is not taken into account in the health policies of Ethiopia. Therefore, this study aimed to identify determinant factors of post-traumatic stress disorder among survivors of road traffic accident patients in Dessie Comprehensive Specialized Hospital, North-East Ethiopia.MethodsA facility-based unmatched case–control study design was employed from February 15 to April 25, 2021, in Dessie Comprehensive Specialized Hospital, with a total sample size of 139 cases and 280 controls selected by using a simple random sampling technique. Data were collected by pretested, interview with a structured questionnaire. The data were entered using Epi-Info, then exported and analyzed using STATA. The bi-variable and multivariable binary logistic regression model was used to identify determinant factors of post-traumatic stress disorder among survivors of road traffic accident. Adjusted odds ratio with a 95% confidence level was used as a measure of association. Variables with a p-value less than 0.05 were considered as statistically significant.ResultA total of 135 cases and 270 controls participated in this study, with a response rate of 97% and 96%, respectively. In the final multivariable analysis, being male [AOR = 0.43, 95% CI: 0.32–0.99], primary educational status [AOR = 3.4, 95% CI: 1.04–11], presence of personal psychiatric history [AOR = 2.12, 95% CI: 1.17–3.92], presence of fracture [AOR = 2.41, 95% CI: 1.2–4.8], witness of death [AOR = 2.25, 95% CI: 1.26–4.30], presence of comorbidity [AOR = 2.29, 95% CI: 1.28–4], good social support [AOR = 0.71, 95% CI: 0.12–0.68] were significantly associated with post-traumatic stress disorder among survivors of road traffic accident patients.ConclusionPTSD following road traffic accidents is common. A multi-disciplinary approach was therefore essential in the management of road traffic accident survivors at the orthopedic and trauma clinics. Patients with poor social support, bone fracture, witnessed death, comorbidity, and females should be routinely screened for post-traumatic stress disorder in all road traffic accident survivors.

Background:Involvement in road traffic accidents (RTAs) may put individuals at increased risk for a wide range of psychiatric disorders, among which posttraumatic stress disorder (PTSD) presents a public health issue. However, a great disparity was observed among studies exploring the prevalence of PTSD among RTA survivors. This meta-analysis aimed to explore the pooled prevalence of PTSD among RTA survivors.Methods:Electronic databases of PubMed, Embase, Web of Science, PsycARTICLES, PsycINFO, and CINAHL were searched to identify relevant studies. Study selection and data extraction were conducted independently by 2 investigators, and a meta-analysis was performed to synthesize the data. Heterogeneity among studies was evaluated using the Cochran Q test and quantified using the I2 statistic. Subgroup analyses were performed to identify the source of the heterogeneity. The possibility of publication bias was assessed using Egger linear test.Results:Fifteen eligible studies containing 6804 RTA survivors were identified in this meta-analysis, of which 1489 were identified with PTSD. The pooled prevalence of PTSD among RTA survivors was 22.25% (95% confidence interval: 16.71%–28.33%). A high degree of heterogeneity was observed across studies (I2 = 97.1%, P < .001), with reported PTSD prevalence ranging from 6.3% to 58.3%. Subgroup analyses found that the prevalence of PTSD among RTA survivors varied significantly across studies in relation to the instrument used to assess PTSD, country, race, gender, and education level (P < .05).Conclusion:The high pooled prevalence of PTSD among RTA survivors found in this study significantly underscores the need for providing timely and effective intervention strategies for RTA survivors.

PTSD among road traffic accident survivors in africa: A systematic review and meta-analysis

PurposePost-traumatic stress disorder (PTSD) is a frequent psychiatric complication in road accident survivors. However, it remains under-explored and is not taken into account in health policies in Benin. The purpose of this study was to determine the prevalence and risk factors of PTSD after a road traffic accident. This will help to improve its diagnosis and management in Benin hospitals.Materials and MethodsAn institution-based cross-sectional study was conducted from November 2020 to January 2021. Consenting victims of road traffic accidents from three hospitals across Benin, aged 18 years and above, living in the south of the country, were administered various questionnaires at 12-month follow-up. Data on PTSD were collected using a pre-tested, structured and standardized post-traumatic stress disorder questionnaire, the PTSD Checklist (specific version) (PCL-S). A logistic regression model was fitted to identify factors associated with PTSD. An adjusted odds ratio (AOR) followed by a 95% confidence interval was calculated to determine the level of significance with a p-value less than 0.05.ResultsOut of 865 patients in the cohort eligible for the 12-month follow-up, 734 (85%) participated in the study. The prevalence of PTSD was 26.43% (95% CI: 23.36–29.75). Factors associated with PTSD on multivariate analysis were female gender (adjusted odds ratio (AOR) = 2.14, 95% CI: 1.38–3.33), hospitalization (AOR = 1.87, 95% CI 1.21–2.89), negative impact of the accident on income (AOR = 4.22, 95% CI: 2.16–8.25), and no return to work (AOR = 3.17, 95% CI: 1.99–5.06).ConclusionThe prevalence of PTSD is high in road accident survivors in Benin. The results of this study highlight the need for early diagnosis and a multidisciplinary approach to the management of PTSD patients in Benin’s hospitals.

Comparatively little is known about the cognitive appraisals and coping styles of child road traffic accident (RTA) survivors that are associated with chronic post-traumatic reactions. Seventy-five children and young people aged 7-18 who were involved in a road traffic accident and attended an accident and emergency department were assessed 8 months after their accident. Post-traumatic symptoms were assessed by diagnostic interview (CAPS-C) and self-report questionnaires (IES). Demographic, accident and injury severity variables were recorded. Informed by the Ehlers and Clark (2000) model, trauma memory, subjective appraisals of the trauma and cognitive coping styles were assessed. Gender was the only non-cognitive variable associated with significant post-traumatic reactions and explained 5-6% of the overall variance. Trauma memory did not significantly contribute to the final regression model. The addition of the remaining cognitive factors assessing subjective appraisals of the trauma and cognitive coping style resulted in the model accounting for 61-65% of the variance of post-traumatic stress disorder (PTSD) symptoms 8 months post trauma. This study adds support to the applicability of the Ehlers and Clark (2000) cognitive model to children. The results indicate that the theoretically determined appraisals and cognitive coping styles are associated with chronic post-traumatic reactions. The findings suggest the need to develop trauma-focused interventions for children that directly address these key cognitions during therapy.

Objectives While the prevalence of posttraumatic stress disorder (PTSD) after road traffic accidents (RTA) has been widely studied, there is a gap in research in the context of China. Therefore, this study aimed to provide a pooled estimation of PTSD prevalence after RTA based on Chinese data and compare it to existing international prevalence. Methods A systematic literature search of English and Chinese databases was performed from their inception dates to December 31, 2024. Chinese patients admitted to a hospital or emergency department after RTA, and without traumatic brain injury following RTA or without PTSD before RTA were included, regardless of type of RTA and whether fracture was sustained. Subgroup analyses were performed on the basis on demographics, assessment methods, income, and comorbidity. Results The inclusion criteria were met by 21 studies. The pooled prevalence of acute stress disorder (ASD) and PTSD was 30% (95% CI, 22%–37%) and 27% (95% CI,22%–32%), respectively, which is higher than the global prevalence of 16% ASD and 22% PTSD. The transition rate of ASD to PTSD was 77% (95% CI, 63%–91%). Females, older adults, and those with lower income had a higher prevalence of PTSD. In addition, the prevalence of PTSD increased with age. Older survivors with comorbidities including anxiety, depression, complication (such as pain, hemorrhagic shock, hypoxemia), diabetes, and hypertension were more likely to suffer from PTSD than older survivors without those comorbidities. Conclusions PTSD after RTA is common, with more than one in four RTA survivors reporting PTSD. Pooled prevalence was higher than that of meta-analysis that had no restrictions on world region.

After participating in this activity, learners should be better able to:• Determine the prevalence of clinician-diagnosed posttraumatic stress disorder (PTSD) in primary care patients• Identify the prevalence of questionnaire-ascertained PTSD symptoms in primary care patients OBJECTIVE: Determine the prevalence of clinician-diagnosed PTSD and questionnaire-ascertained PTSD symptoms in primary care patients. A systematic review of the literature using the PRISMA method, searching MEDLINE, CINAHL, Cochrane Database, PsycINFO, EMBASE, Google Scholar, and relevant book chapter bibliographies. Studies that reported on the prevalence, including point or lifetime prevalence, of PTSD ascertained using diagnostic interviews or self-report questionnaires, or from administrative data, among patients seen in primary care were deemed eligible for inclusion. We abstracted data on the PTSD assessment tool, the mean questionnaire scores/cutoff scores, the time period of PTSD symptoms, and PTSD prevalence reported. Of 10,614 titles screened, 41 studies were eligible for inclusion. The included studies assessed PTSD in a total of 7,256,826 primary care patients. The median point prevalence of PTSD across studies was 12.5%. The median point prevalence in the civilian population was 11.1%; in the special-risk population, 12.5%; and in veterans, 24.5%. The point prevalence of diagnostic interview-ascertained PTSD ranged from 2% to 32.5%, and the point prevalence of questionnaire-based substantial PTSD symptoms ranged from 2.9% to 39.1%. Lifetime prevalence of diagnostic interview-ascertained PTSD ranged from 14.5% to 48.8%. The prevalence of PTSD in administrative data-based studies ranged from 3.5% to 29.2%. PTSD is common in primary care settings. Additional research on effective and generalizable interventions for PTSD in primary care is needed.

BackgroundPost-traumatic stress disorder (PTSD) is prevalent among road traffic accident survivors (RTA), yet the psychological welfare of the persons has largely been ignored as health care professionals focus more on managing physical injuries. Many literatures from other parts of the world have addressed the issue of post-traumatic stress disorder among road traffic accident survivors, but such studies are mostly unavailable in sub-Saharan Africa, especially in Ethiopia. Therefore, this study examined the prevalence and determinants of PTSD among RTA survivors attending selected hospitals in southern Ethiopia.MethodsInstitution based cross-sectional study design was employed from April 1/2018-Sep 30/2019. Data were collected from a sample of consecutively selected 423 RTA survivors through an interviewer-administered technique. A pre-tested post-traumatic stress disorder Checklist-Specific version (PCL-S) tool was used to screen PTSD. Data were entered and analysed using SPSS 22 software. A logistic regression model was fitted to identify determinants of PTSD. An adjusted odds ratio (AOR) with a 95% confidence interval was computed to determine the level of significance with a p-value of less than 0.05.ResultA total of 416 participants were included in the study and the response rate was 98.6%. The prevalence of probable PTSD among RTA survivors was 15.4% (64). After adjusting for the effects of potential confounding variables; time since accident (30–90 days) (AOR = 0.33; 95%CI (0.15, 0.73), history of previous road traffic accident (AOR = 2.67; 95%CI (1.23, 5.77), depressive symptoms (AOR = 2.5, 95% CI (1.10, 6.10)) and common mental disorder (AOR = 12.78, 95% CI (5.56, 29.36)) were significant determinants of PTSD.ConclusionThe prevalence of probable PTSD in the current study was high (15.4%). Time since accident, history of a previous road traffic accident, having depressive symptoms and common mental disorder were significant determinants of PTSD. RTA survivors attending adult Emergency and orthopedic clinics need to be screened for PTSD and get appropriate management.

The traumatised chronic pain patient—Prevalence of posttraumatic stress disorder - PTSD and pain sensitisation in two Scandinavian samples referred for pain rehabilitation

Deficits in working memory (WM) have a role in maintaining posttraumatic stress disorder (PTSD) symptoms, including intrusions, which are a hallmark of PTSD symptomatology. As intrusions are distressing and uncontrollable, it is important to investigate whether PTSD is associated with altered control of proactive interference in WM. Moreover, it is important to consider both verbal and visual WM, as previous research has demonstrated a visual versus verbal dissociation in PTSD. Although previous studies have explored proactive interference in visual and verbal stimuli using a recent probe task, the stimuli used thus far have been non-trauma-related. Therefore, we aimed to investigate proactive interference in PTSD using trauma-related verbal and visual stimuli. Road traffic accident (RTA) survivors with (n = 60) and without PTSD (n = 30) completed a recent probe task to assess proactive interference of visual and verbal trauma-related material. Participants with PTSD displayed significantly more proactive interference than trauma-exposed controls for visual, ηp 2 = .40, and verbal material, ηp 2 = .10, indicating that proactive interference is significantly impaired in PTSD. This demonstrates that further research is warranted and highlights the possibility of considering proactive interference of trauma-related stimuli in therapeutic approaches.