Screening and treating posttraumatic stress, depression and anxiety with early trauma focused cognitive behavioural therapy following traumatic injury
Overview
- Phase
- Phase 1
- Intervention
- Not specified
- Conditions
- Posttraumatic stress symptoms
- Sponsor
- Australian Centre for Posttraumatic Mental Health (ACPMH), Dpt of Psychiatry, University of Melbourne
- Enrollment
- 683
- Status
- Completed
- Last Updated
- 6 years ago
Overview
Brief Summary
The best approach for implementing early psychological intervention for anxiety and depressive disorders after a traumatic event has not been established. This study aimed to test the effectiveness of a stepped model of early psychological intervention following traumatic injury. A sample of 683 consecutively admitted injury patients were screened during hospitalization. High-risk patients were followed up at 4-weeks postinjury and assessed for anxiety and depression symptom levels. Patients with elevated symptoms were randomly assigned to receive 4–10 sessions of cognitive–behavioral therapy (n = 24) or usual care (n = 22). Screening in the hospital identified 89% of those who went on to develop any anxiety or affective disorder at 12 months. Relative to usual care, patients receiving early intervention had significantly improved mental health at 12 months. A stepped model can effectively identify and treat injury patients with high psychiatric symptoms within 3 months of the initial trauma.
Investigators
Eligibility Criteria
Inclusion Criteria
- •Inclusion\- a) A patient with physical injury that requires an admission of at least 24 hours to the trauma service. b) No brain injury or Mild Traumatic Brain Injury.c) Age between 16 and 65 years (parental consent for \<18\).d) A reasonable comprehension of English (defined by proficiency to read and understand the participant information sheet and consent form).
Exclusion Criteria
- •Exclusion:a) Non traumatic injury – defined as patients with an injury that is minor and caused by a non\-traumatic event. This includes minor injury sustained by the following mechanisms of injury:• Falling from a non\-height (e.g., tripping, slipping, fainting)• Domestic accidents (accidents that occur around the home)• Sporting injuries b) Deathc) Age \>65 or \<16d) Satellite admission – in some cases patients are kept in wards for observation, usually because their injuries are relatively minor. Those in observation wards are not included in the study.e) Brain injury is greater than mild f) The injury is a result of deliberate self\-harm g) The individual has a history of or current psychotic disorderh) A temporary Australian visitor (e.g., tourist)i) Non English speakerj) Admission \<24 hoursk) Actively suicidall) Cognitive impairmentm) Under police guardn) Missed patients
Outcomes
Primary Outcomes
Not specified