Statement of purpose To appraise the ability of two short clinical screeners designed to predict future development of post-injury depression and PTSD in traumatically injured patients.
Methods/Approach This study is part of a prospective longitudinal cohort study to improve the health of urban Black men after serious injury. The sample consisted of English-speaking, self-identified Black men at least 18 years old, residing in the Philadelphia metropolitan area, who were hospitalized for an acute traumatic injury. The two screeners used were the Penn Richmond Screener (PRS) and the Posttraumatic Adjustment Screen (PAS).
Results A total of 623 participants completed baseline interviews. Over 80% completed the 3-month follow-up interview and had complete data for depression (n = 502) and PTSD (n = 501). Of these, 177 (35.3%) met criteria for depression and 145 (28.8%) for PTSD; 116 participants met criteria for both depression and PTSD (23.2%). Both screeners have similar positive predictive values (PPV) for depression. PAS performs slightly better in PPV for PTSD. Both screeners have high negative predictive values for PTSD and depression, so they will adequately identify individuals who will not develop symptoms. The area under the curve for PTSD and depression in both screeners is similar, so they similarly classify those with and without future risk of symptom development.
Conclusion PRS and PAS, developed through different methods and with different populations, show comparable predictive ability within the study population. Thus, mental health outcomes can be predicted in various populations using screeners the clinician values for brevity over the similarity of patient population to the screener’s test population.
Significance ACS-COT encourages screening all patients for depression and PTSD risk. Integrating a predictive screener prior to discharge is critical to identifying those at risk and targeting patients who would benefit from post-discharge concurrent screening.
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