Comorbidity characteristics of PTSD with anxiety and depression in patients with accidental injuries: Findings from joint cross-sectional and longitudinal studies.

BACKGROUND

This study aims to analyze the dynamic symptom interaction pathways and temporal causal relationships among post-traumatic stress disorder (PTSD), anxiety, and depression in patients with accidental injuries, and to establish a system of psychological intervention targets for this population.

METHODS

This prospective longitudinal study was conducted from November 2023 to December 2024 in three tertiary general hospitals in Southwest China. Baseline assessments were completed 3-10 days post-trauma (T0), followed by follow-ups at 1 month (T1), 3 months (T2), and 6 months (T3).

RESULTS

382 patients who completed T1 follow-up were included as the main analysis samples. The comorbidity rates of PTSD, anxiety and depression decreased gradually (T1 = 22.8 %, T2 = 21.2 %, T3 = 15.6 %). The longitudinal psychopathological network analysis showed that PTSD9 (Loss of interest) and D1 (Anhedonia) (edge weight = 0.22) were the main connections in T1 stage. In T2, A3 (Worrying) and D6 (Depressed mood) (edge weight = 0.30) were added. At T3 stage, there were positive emotional correlation between A4 (Relaxed feeling) and D7 (Enjoyment of activities) (edge weight = 0.21). Cross-lagged panel model analysis indicated that depressive symptoms positively predicted subsequent PTSD symptoms (T1 → T2: β = 0.583, P < 0.01; T2 → T3: β = 0.792, P < 0.05) and anxiety symptoms (T1 → T2: β = 0.268, P < 0.05; T2 → T3: β = 0.282, P < 0.001).

CONCLUSION

There was a dynamic evolution of PTSD, anxiety, and depression following accidental injuries, highlighting the need to establish temporally targeted intervention pathways to disrupt the pathogenic process.