Addiction, posttraumatic stress disorder and motor vehicle accidents

Eight to 40% of Subjects confronted with a motor vehicle accident present with a posttraumatic stress disorder (PTSD). Besides its professional, functional social, environmental impact, PTSD increase the risk comorbide substance use disorder. We present a prospective epidemiological long-term study of a population of 273 patients victims of a motor vehicle accident hospitalized in Trauma & Orthopedic Department with 6 months follow-up. We find a Post-Traumatic Stress Disorder (PTSD) rate in accordance with literature: 20.8% (6 weeks after accident) and 16.6% (6 months after the accident) for the whole population. We did not note increase of substance abuse disorder (alcohol or opiates) (6 weeks or 6 months after the accident) for the whole population (or even a reduction). But we found a more important proportion of PTSD in patients initially presenting with substance abuse disorder at 6 weeks and at 6 months. On the other hand, we found an increase of substance misuse in patients presenting with a PTSD (at 6 weeks and 6 months) in comparison with of general population. We discuss how initial substance abuse disorder could impact on psychopathological disorders onset afterwards and the importance of early screening as part of the secondary prevention for PTSD using itinerant unit of addictology and/or psychiatry (i.e. Consultation Liaison Addictology and Psychiatry). (c) 2009 Elsevier Masson SAS. All rights reserved.