DEPITAC : Short Screening Scale for Psychotraumatic Disorders After Motor Vehicle Accident

Overview

Posttraumatic stress disorder (PTSD) is a serious and often chronic response to overwhelmingly stressful events as Road Traffic Accident. Moreover PTSD is associated with increased rates of medical morbidity, poor health-related quality of life, and functional impairment. PTSD is prevalent in primary care settings after road traffic accident, where approximately 25% of patients meet diagnostic criteria for the disorder. Despite the development of a number of efficacious behavioral and pharmacological treatments, only a minority of patients with PTSD receive mental health services. PTSD is frequently underrecognized and untreated in Emergency Department and Surgical Unit. Then, early diagnosis and prevention of PTSD might help to identify patients with PTSD high risk and lead them to benefit of personalized cares. Nevertheless it is not possible (neither useful) to provide psychological cares for each road traffic accident victim. This is the reason why we think that nurses can help to screen patients who need treatment for PTSD Hypothesis : Recognition of specific clinical or biological signs occurring during road traffic accident victim hospitalization in surgical unit could allow beginning specific treatment using consultation liaison psychiatry. Early treatment could allow decreasing incidence of psychotraumatic disorders, increasing surgical functional efficacy and improve convalescence programs. The use of a specific questionnaire could help to screen this disorder. We have created the DEPITAC scale : a short screening questionnaire with 10 items. This study will be evaluated DEPITAC's 10-item screen for posttraumatic stress disorder (PTSD) for use in surgical or emergency department.

We include 300 road traffic accident victims hospitalized in surgical department (less than 2 weeks). Patients are hospitalized in 5 different hospitals (3 in Lille, 1 in Douai, 1 in Paris). Patients will be evaluated by a short screening questionnaire (DEPITAC's 10 item screen). Patients will be evaluated by phone with a experimented psychologist (Minimal International Neuropsychiatric Interview DSM IV, PTSD Check List symptoms) at 6 weeks, 6 months and 1 year after the accident. Purposes : * To evaluate DEPITAC's 10-item screen for posttraumatic stress disorder (PTSD) for use in surgical or emergency department. * To measure prognosis value of DEPITAC's 10 item screen on acute PTSD (PTSD Check List symptoms (PCLs) 6th week) and late PTSD (PTSD Check List symptoms (PCLs) 6 months and 1 year) or other psychiatric disorder (anxiety, depression or addictive disorder) (Minimal International Neuropsychiatric Interview MINI DSM IV at 6 months and 1 year). * To compare DEPITAC to Peritraumatic Distress Inventory (PDI) given a the same time. * To calculate DEPITAC's total score and correlate to the onset of a PTSD at 6 week, 6 months and 1 year.