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Hindi Research Article
Estimates of Prevalence and Criteria Comparison in DSM-5 versus DSM-IV-TR Post-Traumatic Stress Disorder in 111 Survivors to the 2009 Railway Accident in Viareggio-Italy
Mauro Mauri1, Alberto Petracca1, Mario Miniati2, Sara Fratta1, Erika Fui1, Ilenia Giunti1, Giulia Macchia1, Michela Giorgi Mariani1, Enrico Calderani1, Camilla Gesi1, Claudia Carmassi1*, Liliana Dell’Osso1
1Section of Psychiatry, Department of Clinical and Experimental Medicine, University of Pisa, Pisa, Italy
2Consultant Psychiatrist, 2nd Psychiatry Unit of the University Hospital of Pisa, Pisa, Italy
Abstract
The fifth edition of the Diagnostic and Statistical Manual of Mental Disorders (DSM-5) introduced noteworthy revisions to Post-Traumatic Stress Disorder (PTSD) criteria, including a four-factor model and some new symptomatic criteria. To date, only a limited number of studies investigated the impact of such changes on the prevalence rates of the disorder. On 29 June 2009, in the railway station of Viareggio (Italy), a freight train carrying liquefied petroleum gas derailed with a subsequent fire leading to a large area of the town being damaged: 32 people died and 26 were severely injured. A total sample of 111 subjects who survived to the railway accident were assessed for PTSD according to either DSM-5 or DSM-IV-TR criteria by means of a spectrum assessment instrument: the Trauma and Loss Spectrum-Self Report (TALS-SR). A DSM-5 PTSD diagnosis emerged in 50.4% with respect to 54.7% according to DSM-IV-TR criteria. Most of the subjects fulfilling DSM-IV-TR but not DSM-5 criteria did not endorse new Criterion C (active avoidance). For what concern new DSM-5 PTSD symptoms: 1 (2.6%) survivor endorsed symptom D3; 29 (76.32%) D4; 6 (15.79%) both D3 and D4; 8 (27.59%) E2. This is the first study to report PTSD prevalence rates among survivors to the Viareggio 2009 railway accident. Our results corroborate the substantial equivalence between the DSM-5 and DSM-IV-TR algorithms for PTSD diagnosis and further suggest that avoidance and/or negative alterations in cognition and mood should alert the clinician for possible PTSD development.
