Abstract
Not only has accidental injury been shown to account for a significant health burden on all populations, regardless of age, sex and geographic region, but patients with accidental injury frequently present with the psychiatric condition of posttraumatic stress disorder (PTSD). Prevention of accident-related PTSD thus represents a potentially important goal. Physicians in the field of psychosomatic medicine and critical care medicine have the opportunity to see injured patients in the immediate aftermath of an accident. This article first briefly reviews the prevalence and associated factors of accident-related PTSD, then focuses on a conceptual model of fear memory and proposes a new, rationally hypothesized translational preventive intervention for PTSD through promoting hippocampal neurogenesis by omega-3 fatty acid supplementation. The results of an open-label pilot trial of injured patients admitted to the intensive care unit suggest that omega-3 fatty acid supplementation immediately after accidental injury can reduce subsequent PTSD symptoms.
Highlights
Posttraumatic stress disorder (PTSD) is a serious public health problem
We showed that infant mortality rate was associated with the prevalence of PTSD and as such, our study findings could provide a plausible explanation for the observed discrepancies seen in the prevalence of PTSD following injury [25]
This review has highlighted the major epidemiologic findings of PTSD and possible nutritional intervention that could be implemented in the aftermath of accidental injury for prevention or amelioration of the disorder
Summary
It is difficult to eliminate traumatic antecedents altogether, but preventive intervention for PTSD does seem possible. Compared with the hypothetical mean in our previous cohort study [84], omega-3 fatty acid supplementation resulted in a significantly reduced mean CAPS total score (11 vs 25, p = 0.03), and over the 12-week period, only one patient (1/ 15, 6.7%) developed symptoms consistent with a diagnosis of both PTSD and major depression. Because of the open-label design and the lack of controls, no definitive conclusion could be drawn from the trial and we must wait for the results of an adequately powered randomized controlled trial (ClinicalTrials.gov Identifier: NCT00671099) (Figure 3) This pilot study has provided promising support for our hypothesis that omega-3 fatty acid supplementation started shortly after accidental injury may be efficacious in attenuating PTSD symptoms
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