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Peritraumatic distress but not dissociation predicts posttraumatic stress disorder in the elderly

Published online by Cambridge University Press:  22 February 2013

Alain Brunet ,
Steven Sanche ,
Aude Manetti ,
Bruno Aouizerate ,
Régis Ribéreau-Gayon ,
Sandrine Charpentier ,
Philippe Birmes  and
Christophe Arbus
Alain Brunet
Affiliation:
McGill University and Douglas Mental Health University Institute, Montréal, Quebec, Canada
Steven Sanche
Affiliation:
St. Mary's Research Centre, St. Mary's Hospital, Montréal, Quebec, Canada
Aude Manetti
Affiliation:
PRES Sorbonne Paris Cité, Assistance Publique-Hôpitaux de Paris, Department of Psychiatry, Corentin Celton Hospital, Issy les Moulineaux, Paris Descartes University, Paris, France
Bruno Aouizerate
Affiliation:
Academic Department of Adult Psychiatry, Charles Perrens Hospital, Bordeaux Segalen University, Bordeaux, France
Régis Ribéreau-Gayon
Affiliation:
Adult Emergency Department, Pellegrin Hospital, Bordeaux, France
Sandrine Charpentier
Affiliation:
INSERM 558, Emergency Department, Purpan University Hospital, Toulouse University, Toulouse, France
Philippe Birmes
Affiliation:
Department of Psychiatry and Medical Psychology, Traumatic Stress Laboratory (EA 4560), Purpan University Hospital, Paul Sabatier University (UPS), Toulouse, France
Christophe Arbus*
Affiliation:
Department of Psychiatry and Medical Psychology, Traumatic Stress Laboratory (EA 4560), Purpan University Hospital, Paul Sabatier University (UPS), Toulouse, France
*
Correspondence should be addressed to: Christophe Arbus, MD, PhD, Department of Psychiatry and Medical Psychology, Purpan-Casselardit Hospital, 31059 Toulouse, France. Phone: +33-5-6177-2351; Fax: +33-5-6177-7646. Email: [email protected].
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Abstract

Background: Post-traumatic stress disorder (PTSD) is a severe anxiety disorder whose symptoms include re-experiencing, avoidance, and hyperarousal after a particularly intense event. In view of the aging of the population, increased clinical knowledge is required for better understanding of PTSD in the elderly. Extending previous research in this field in adults and children, the aim of our study was to assess the utility of peri-traumatic dissociation and distress as a predictor of PTSD in the elderly.

Methods: A prospective longitudinal study was conducted in a consecutive cohort of subjects aged 65 years and over admitted to emergency departments after a physical assault or a road traffic accident. Peri-traumatic responses of distress and of dissociation were measured. One, 6, and 12 months after trauma exposure, PTSD symptoms and diagnosis were assessed using both a dimensional and a semistructured interview.

Results: Thirty-nine male and female participants with an average age of 72.4 years were recruited. Mixed model regression analyses did not detect a significant effect of age, sex, nor time. Significant associations were detected between peri-traumatic distress and the self-report PTSD Checklist (p = 0.008), as well as the Clinician-administered PTSD scale (p = 0.03). No association was detected between peri-traumatic dissociation and PTSD.

Conclusions: Peri-traumatic distress predicts PTSD symptoms and diagnosis in the elderly, thereby suggesting its systematic evaluation at the emergency department would be a worthwhile thing to do.

Keywords

traumaagingperi-traumatic responsesdistressdissociative experiencerisk factors
Type
Research Article
Information
International Psychogeriatrics , Volume 25 , Issue 6 , June 2013 , pp. 1007 - 1012
Copyright
Copyright © International Psychogeriatric Association 2013

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