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5 results

  • Chapter 7 - Accidents and Injuries during Seizures

  • Edited by Marco Mula, St George's Hospital Medical School, University of London
  • Book:
    Post-traumatic Epilepsy
    Published online:
    10 August 2021
    Print publication:
    26 August 2021, pp 97-103

  • Summary

    Epilepsy that develops following traumatic brain injury (TBI) significantly increases the risk for disability in patients with epilepsy. The house, street and workplace are the leading sites where accidents and injuries occur in patients with epilepsy. Some of the accidents and injuries may be the consequence of seizures themselves, as for example shoulder dislocation during a tonic-clonic seizure or tongue biting . Seizure-related injuries have been classified into burns, head trauma, dental traumas, fractures, major body injuries, penetrating traumas, road injuries, and drowning. Noteworthy, a patient could have one or more injuries at different body locations during a seizure or multiple injuries with different seizures.

    Comorbid conditions and concurrent handicaps, neurological and cognitive deficits, behavioral and psychiatric disorders as well as side effects of antiepileptic medications, like drowsiness, ataxia, blurred vision, and diplopia, may be present in patients with epilepsy and act as independent putative causes of accidents and injuries.

    Accidents and injuries that occur during seizures may require hospitalization, cause disability, influence the ability to drive and restrict driving license, increase lost work productivity and indirect costs, decrease self-esteem, contribute to social stigmatization and, hence, affect the overall quality of life in patients with epilepsy.

  • Heart rate measured in the acute aftermath of trauma can predict post-traumatic stress disorder: A prospective study in motor vehicle accident survivors

  • R. Coronas, O. Gallardo, M.J. Moreno, D. Suárez, G. García-Parés, J.M. Menchón
  • Journal:
    European Psychiatry / Volume 26 / Issue 8 / November 2011
    Published online by Cambridge University Press:
    16 April 2020, pp. 508-512
  • Objective

    To determine whether increased physiological arousal immediately after trauma or at emergency admission can predict post-traumatic stress disorder (PTSD) in motor vehicle accident (MVA) survivors with physical injuries.

    Methods

    We included 119 MVA survivors with physical injuries. In this prospective cohort study, heart rate (HR) and blood pressure (BP) were assessed during ambulance transport (T1) and at hospital admission (T2). One and four months after the accident, we assessed patients for PTSD (Davidson trauma scale, confirmed with the structured clinical interview for DSM-IV axis I disorders). Multivariate logistic regression models assessed the relationship between HR or BP and PTSD.

    Results

    PTSD was diagnosed in 54 (45.4%) patients at 1 month and in 39 (32.8%) at 4 months. In the multivariate analysis, HR at T1 or at T2 predicted PTSD at 1 month (OR=1.156, 95% CI [1.094;1.221] p < 0.0001). Only HR at T1 (not at T2) predicted PTSD at 4 months (OR=1.059, 95% CI [1.013; 1.108] p = 0.012). Injury severity predicted PTSD at 4 months (OR=1.207, 95% CI [1.085; 1.342] p = 0.001). A cut-off of 84 beats per minute yielded a sensitivity of 62.5% and a specificity of 75.0% for PTSD.

    Conclusions

    HR measured at the scene of MVA and severity of injury predicted PTSD 4 months later.

  • 10 - Debriefing and motor vehicle accidents: interventions and outcomes

  • from Part II - Debriefing: models, research and practice
  • Edited by Beverley Raphael, New South Wales Health Department, Sydney, John Wilson, Cleveland State University
  • Book:
    Psychological Debriefing
    Published online:
    06 January 2010
    Print publication:
    12 October 2000, pp 145-160

  • Summary

    This chapter summarizes the available data about the psychiatric impact of motor vehicle accidents (MVAs), and examines the aetiology of these effects. It discusses the studies of debriefing interventions designed to prevent the adverse effects. The chapter explores the question about how these may be limited or treated. The psychiatric consequences of MVAs are in many ways similar to those described for acute illnesses and events but, a small proportion of victims suffer cognitive and other disorders due to head injury and brain damage and many suffer from post-traumatic syndromes. Post traumatic stress disorder (PTSD) is very frequent following MVAs. Psychological debriefing has been conceptualized as an intervention that promotes adaptive adjustment to traumatic events, in part through facilitating emotional and cognitive processing of the experience. The evidence cited here suggests that psychological debriefing for individuals after road accidents does not reduce later psychiatric problems, particularly specific post-traumatic symptoms.

  • COGNITIVE FACTORS IN TRAUMATIC STRESS REACTIONS: PREDICTING PTSD SYMPTOMS FROM ANXIETY SENSITIVITY AND BELIEFS ABOUT HARMFUL EVENTS

  • Ingrid C. Fedroff, Steven Taylor, Gordon J. G. Asmundson, William J. Koch
  • Journal:
    Behavioural and Cognitive Psychotherapy / Volume 28 / Issue 1 / January 2000
    Published online by Cambridge University Press:
    01 November 2001, pp. 5-15
    Print publication:
    January 2000

  • The present study evaluated the relative importance of different cognitive factors (anxiety sensitivity and trauma-related beliefs) in predicting PTSD symptom severity and treatment-related changes in these symptoms. Eighty-one victims of motor vehicle accidents (MVAs) completed self-report measures of PTSD symptoms, anxiety sensitivity (AS), MVA-related beliefs and control variables (e.g., medication use, pain severity). A subsample of patients (n=28), who received cognitive-behavioural treatment for PTSD, completed these measures pre- and post-treatment. For the combined sample (n=81), regression analyses indicated that AS and pain severity were significant predictors of PTSD symptoms, whereas MVA-related beliefs were not. For patients completing treatment, regression analyses indicated that reductions in AS and pain severity were significant predictors of reductions in PTSD symptoms. MVA-related beliefs did not significantly predict symptom reduction once AS, pain severity and medication status was controlled for. These findings suggest that AS is a significant cognitive risk factor for exacerbating and maintaining PTSD symptoms. Treatment implications are discussed.