Early psychological reactions in a group of individuals with pre-existing and enduring mental health difficulties following a major coach accident

BACKGROUND The impact of major trauma on individuals with pre-existing and enduring mental health difficulties is poorly understood. METHOD Twenty individuals with pre-existing and enduring mental health difficulties were assessed with the Clinician Administered Post Traumatic Stress Disorder Scale, the 28-item version of the GHO, the Hospital Anxiety and Depression Scale, and the impact of Event Scale between four and eight weeks after their involvement in a major coach accident. RESULTS Ten (50%) individuals satisfied the full DSM-IV criteria for a diagnosis of PTSD. The questionnaire scores indicated a high level of psychological suffering among the group. On dividing the sample into those individuals with previous diagnosis of anxiety or depressive disorders and those with a previous diagnosis of chronic schizophrenia, the schizophrenia group displayed less marked psychological sequelae on all measures. CONCLUSION There was a high incidence of early psychological sequelae among the group as a whole. Some diagnoses (e.g. depression and anxiety) may predispose to psychological sequelae while others (e.g. chronic schizophrenia) may not