Background: Posttraumatic stress disorder (PTSD) is a psychiatric disorder that results from exposure to a traumatic event and consists of intrusive and unwanted recollections; avoidance followed by emotional withdrawal; and heightened physiologic arousal. Hospitalized victims of suicide bombing attacks (SBAs) are unique because of the circumstances and severity of their injuries, which could affect the occurrence and delay the recognition of PTSD. Our objectives were to evaluate the prevalence and severity of PTSD among hospitalized SBA victims and to assess variables of physical injury as risk factors for the development of PTSD.
Methods: Forty-six hospitalized SBA victims were evaluated for PTSD using the PTSD symptom scale self-report questionnaire by phone. Demographic and medical data regarding the severity and type of injury and medical treatment were collected from medical files. Injury Severity Score was used to assess severity of physical injury.
Results: Twenty-four of 46 (52.2%) hospitalized SBA victims developed PTSD. Presence of blast lung injury was significantly higher in the PTSD group compared with the non-PTSD group (37.5% versus 9.1%, respectively; p < 0.04). There was no significant difference in Injury Severity Score between PTSD and non-PTSD groups. Blast lung injury and intracranial injury were found to be positive predictors of PTSD (odds ratio, 125 and 25, respectively). No correlation was found between the length of stay, length of intensive care unit stay, or severity of physical injuries and the severity of PTSD.
Conclusions: Hospitalized victims of SBA are considerably vulnerable to develop PTSD. Victims should be monitored closely and treated in conjunction with their physical treatment. Blast lung injury and intracranial injury are predictors of PTSD.
From the Departments of Surgery and Trauma Unit (N.S., A.M., G.Z., M.A.G., A.I.R., Y.I., M.B., G.A.) and Psychiatry (A.S.), Hadassah-Hebrew University Medical Center, Jerusalem, Israel.
Submitted for publication February 17, 2010.
Accepted for publication October 21, 2010.
Presented on the podium at the 11th European Congress of Trauma and Emergency Surgery (ESTES), May 2010, Brussels.
Noam Shussman and Ayelet Mintz contributed equally to this work.
Address for reprints: Gidon Almogy, MD, Department of Surgery, Hadassah-Hebrew University Medical Center, POB12000, Jerusalem 91120, Israel; email: GAlmogy@hadassah.org.il.