TY  - JOUR
PY  - 2010//
TI  - A predictive screener for depression & PSTD after physical injury
JO  - Injury prevention
A1  - Richmond, T. S.
A1  - Ackerson, Theimann H.
A1  - Ruzek, J.
A1  - Wiebe, D.
A1  - Winston, Flaura Koplin
A1  - Kassam-Adams, N.
SP  - A76
EP  - A77
VL  - 16
IS  - Suppl 1
N2  - Aim To develop a predictive screener that will accurately predict the future development of postinjury depression or post-traumatic stress disorder (PTSD).  Methods A prospective, longitudinal cohort study of subjects randomly selected from patients requiring an Emergency Department (ED) visit for injury. A theoretically and empirically derived 45-item risk survey was administered soon after injury. A psychiatric diagnostic interview was conducted at 3 and 6 months to determine emergence of depression or PTSD. Multiple logistic regression analyses were performed separately for depression and PTSD, using a best-subset approach to select models at each step by comparing log-likelihood estimates.  Results Of 175 (of 192 enrolled) available for follow-up, 16% developed depression and 2.3% developed PTSD. A logistic model retaining four depression items and five PTSD items emerged. One item predicted both depression and PTSD; hence the final screener is eight items. Receiver operating characteristic for depression and PTSD was 0.81 each. Optimal cut-off scores were >2 (out of 4) for depression and >3 (out of 5) for PTSD. Depression findings: sensitivity 0.81, specificity 0.71, PPV 0.34, NPV 0.95. PTSD findings: sensitivity 1.00, specificity 0.66, PPV 0.07, NPV 1.00.  Conclusions Thirty million seek ED care annually for injury and a significant subset develop psychiatric disorders that that impede recovery. The high NPV for both depression and PTSD supports the role of this new instrument as a short, clinical screener: those who screen negative can be screened out from further monitoring, allowing precious resources to be focused on those at highest risk for the development of depression and PTSD.<p /> 
LA  - en
SN  - 1353-8047
UR  - http://dx.doi.org/
ID  - ref1
ER  -