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**5** 

**Peritraumatic Distress in Accident Survivors:** 

In 1997, the Global Burden of Disease Study (Murray, 1997) predicted that by 2020 motor vehicle accident would be the third biggest contributor to worldwide burden of disease. With more than 50 million people reported in 2007 to be injured each year in road traffic accidents worldwide (Derriks & Mark, 2007), motor vehicle accidents are indeed contributing highly to burden of disease. Moreover, such accidents are regarded as one of the leading causes of posttraumatic stress disorder in today's world. As advances in injury care systems have increased the number of seriously injured people who are able to survive their injuries (MacKenzie et al., 2006 ), this has drawn increasing attention to psychiatric

Recent studies have shown that accident-related posttraumatic stress disorder is fairly common. The prevalence of posttraumatic stress disorder determined by structured clinical interviews with injured patients consecutively admitted to the intensive care unit or emergency department ranges from 5–30% at 0–3 months after injury to 2–23% at 4–12 months after it (Bryant et al., 2010; Hamanaka et al., 2006; Hepp et al., 2008; Matsuoka et al., 2008; Matsuoka, Nishi, Yonemoto, Nakajima et al., 2010; O'Donnell et al., 2004; Schnyder, Moergeli, Klaghofer et al., 2001; Schnyder et al., 2008; Shalev et al., 1998). Recent large epidemiological studies using questionnaires have reported a 17–23% point prevalence of clinically significant posttraumatic stress disorder symptoms at 4–12 months after injury (Zatzick et al., 2007; Mayou et al., 2001). It is well known that this disorder can be associated with higher psychiatric comorbidity, attempted suicide, and physical illnesses such as asthma, hypertension, and peptic ulcer (Davidson et al., 1991), as well as carry high healthcare costs ( O'Donnell et al., 2005; Walker et al., 2003). It remains, therefore, a serious public health problem that needs to be addressed (Kessler et

**1. Introduction** 

morbidity after injury among such survivors.

al., 1995; Kessler et al., 2005.)

**An Indicator for Posttraumatic Stress,** 

Daisuke Nishi1,2, Masato Usuki1,2,4 and Yutaka Matsuoka1,3

**Depressive and Anxiety Symptoms,** 

**and Posttraumatic Growth** 

*3National Center for Neurology and Psychiatry,* 

*1National Disaster Medical Center, 2Japan Science and Technology Agency,* 

*4Kyushu University,* 

*Japan* 

