Illness and injury and PTSD

Prevalence in medical patients

What is prevalence of PTSD in medical patients?

Prevalence represents the overall proportion of individuals in a population who have the disorder of interest. It is different from incidence, which represents only the new cases that have developed over a particular time period.

What is the evidence for the prevalence of PTSD in medical patients?

Moderate quality evidence finds the overall prevalence of PTSD in primary care settings (first-contact medical care centres) is around 12.5%. In critical illness survivors, the prevalence of PTSD diagnosis is 20% between discharge from ICU and over 12 months post-discharge. Rates were highest within the first 3 months post-discharge. The prevalence of PTSD symptoms in critical illness survivors is between 25% and 44% up to 6 months post-ICU. Rates vary depending on the Impact of Event Scale score cut-off threshold. By 12 months, rates were between 17% and 34%.

The prevalence of PTSD diagnosis following a coronavirus infection was around 29-32%. Coronavirus infections include the severe acute respiratory syndrome (SARS), the Middle East respiratory syndrome (MERS), and the coronavirus disease 2019 (COVID-19). Rates of PTSD were higher in females than in males following a coronavirus infection. Rates were highest in healthcare workers, in people with a previous physical illness, and in people with avascular necrosis. They were also highest in those with functional impairment, pain, and a sense of lack of control.

The prevalence of PTSD after a traumatic brain injury (TBI) is around 24%. Rates were highest in samples with more males. They were highest in samples with TBI rather than another physical injury, and in military samples exposed to a blast rather than civilians exposed to a motor vehicle accident. They were also highest in studies from the USA. There were no differences in rates of PTSD between people with a mild or moderate/severe TBI.

The prevalence of PTSD after acute orthopaedic trauma is around 26.6%. The prevalence of both PTSD and depression is around 16.8%. Rates were higher in females than males with orthopaedic trauma. They were also higher in patients with lower extremity fractures (including pelvic) than upper extremity fractures.

In people with cancer, the current prevalence of PTSD is around 5-6% and lifetime prevalence is around 12-15%. After an acute coronary event, the prevalence of PTSD is around 12%, with rates higher in studies using a screening instrument than a clinical diagnostic interview to assess PTSD. Within one year after a stroke or transient ischemic attack, the prevalence is around 23% and around 11% after one year. After a caesarean section, prevalence is around 10.7%, with rates higher after an emergency caesarean than after an elective caesarean. The prevalence of PTSD in HIV-positive women is around 30%, with rates proposed to be lower in HIV-positive men.

Prevalence of PTSD symptoms after a burn injury ranged from 3.3% to 35.1% at 1 month, 2.2% to 40% at 3 to 6 months, 9% to 45.2% within the year post-injury, and 6.7% to 25.4% more than 2 years later.

The prevalence of PTSD in people with chronic pain is around 9.7%. PTSD prevalence was highest in people with chronic widespread pain and headache, and lowest in people with back pain. Prevalence was higher in studies using self-reported PTSD symptoms than in studies using clinical interviews to assess PTSD.

The prevalence of PTSD after an injury in children is around 20.52%. Rates were highest in girls, in older children, and in children injured in hurricanes.

August 2021

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Last updated at: 12:55 am, 26th October 2021
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