The development of psychological reactions in a group of individuals with pre-existing and enduring psychiatric disorder following a fatal coach crash

Abstract

This study examines the incidence of post traumatic stress disorder (PTSD) and other psychological sequelae following a fatal coach crash in a group of individuals with pre-existing and enduring psychiatric disorder. Twenty-four patients had been assessed using the GHQ, IES, HADS and the CAPS structured interview at 5 weeks and this follow-up study re-evaluates these subjects, along with nine non-patients at 9 months. Rates of PTSD of 50% and 37.5% and rates of 69-100% and 50-81% for psychological disturbance in general, were obtained, respectively. The rates over the whole group are comparable with those for general populations. There was significant stability over time. Significantly lower rates of PTSD were obtained objectively for the schizophrenia group than the group with other diagnoses and the non-patient group. Subjectively, the schizophrenia group responded in a similar way to the non-patient group, while the non-schizophrenia patient group displayed a higher rate of post-trauma psychological disturbance. Absence of schizophrenia was the main predictor of poorer outcome over 9 months.