Prediction of Posttraumatic Stress and Depression One-Month Post-Injury: A Comparison of Two Screening Instruments

Objective: To examine the combined and individual utility of 2 screening tools in prediction of depression and PTSD one-month post traumatic injury. Method: 484 Level I Trauma Center patients were administered the Peritraumatic Distress Inventory (PDI) and Injured Trauma Survivor Screen (ITSS). Approximately 30 days post-injury, patients completed the Posttraumatic Stress Disorder Checklist for DSM-5 (PCL-5) and Patient Health Questionnaire (PHQ-8). Results: Receiver operating characteristic curve (ROC) curves for the PDI suggested a cutoff score of 17.5 predicting PTSD (Sensitivity = 70%; Specificity = 62%) and depression (Sensitivity = 74%; Specificity = 64%). For the ITSS, ROC curves suggested a cutoff score of 1.5 to predict PTSD (Sensitivity = 72%; Specificity = 60%) and depression (Sensitivity = 67%; Specificity = 62%). Inclusion of both instruments in regression analyses accounted for 2.4%-6.8% greater variance than 1 measure alone in predicting PCL-5 and PHQ-8 scores. Conclusions: The ITSS and PDI each demonstrated significant clinical utility in practice. Use of both measures, versus either alone, likely does not produce sufficient added clinical benefit. Follow-up screening and/or ongoing symptom monitoring is recommended as an adjunct to brief bedside screening.