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Beyond the neglect of psychological consequences: posttraumatic stress disorder increases the non-fatal burden of injury by more than 50%
  1. J A Haagsma*,
  2. S Polinder,
  3. H Toet,
  4. M Panneman,
  5. A H Havelaar,
  6. G J Bonsel,
  7. E F van Beeck
  1. Correspondence Erasmus Medical Centre, P.O. Box 2040 Rotterdam, The Netherlands


Introduction Psychological consequences such as post-traumatic stress disorder (PTSD) are currently neglected in burden of injury calculations. The aim of this study was to assess the disease burden of PTSD due to unintentional injury and compare this with health loss to physical injury consequences.

Methods From literature sources, the prevalence rate of PTSD at four follow-up periods (<3 months, 3–6 months, 7–12 months and >12 months) was estimated. The uncertainty of the estimated PTSD prevalence rate was modelled by using a Bayesian approach. The prevalence rates were then linked to national data on unintentional injury, disability weights and duration to estimate the incidence and Disability Adjusted Life Years (DALY) resulting from PTSD in addition to physical injury consequences.

Results The data suggest that PTSD prevalence rate among injury victims decreases over time. The average PTSD prevalence rate at <3 months follow-up was 21% for patients presenting at the ED and 30% for patients that were hospitalised, after 12 months tapering down to 4% and 6% respectively. These estimates translate into 191 000 cases of PTSD per year in the Dutch population (1.2%) due to unintentional injury. Including PTSD increases the non-fatal burden of disease of unintentional injuries by 53% from 116 000 to 178 000 DALYs.

Conclusions Ignoring PTSD in burden of injury studies results in a considerable underestimation of the burden of injury. This may impact resource allocation and the identification of important prevention priorities.

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