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The efficacy of initial hydrocortisone administration at preventing posttraumatic distress in adult trauma patients: a randomized trial
Open accessAbstract
UNLABELLED: OBJECTIVE/INTRODUCTION: Secondary pharmacological interventions have shown promise at reducing the development of posttraumatic stress disorder symptoms (PTSS) in preclinical studies. The present study examined the preliminary efficacy of a 10-day low-dose (20 mg bid) course of hydrocortisone at preventing PTSS in traumatic injury victims. METHODS: Sixty-four traumatic injury patients (34% female) were randomly assigned in a double-blind protocol to receive either a 10-day course of hydrocortisone or placebo initiated within 12 hours of the trauma. One-month and 3-months posttrauma participants completed an interview to assess PTSS and self-report measures of depression and health-related quality of life. RESULTS: Hydrocortisone recipients reported fewer PTSD and depression symptoms, and had greater improvements in health-related quality of life during the first 3 months posttrauma than did placebo recipients. Hydrocortisone recipients who had never received prior mental health treatment had the lowest PTSD scores. CONCLUSION: Low-dose hydrocortisone may be a promising approach to the prevention of PTSD in acutely injured trauma patients, and may be particularly efficacious in acutely injured trauma victims without a history of significant psychopathology.
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“Similarly, in another recent report of 64 traumatic injury patients it was demonstrated that those who received a 10-day course of low dose oral hydrocortisone started within 12 hours of the injury reported fewer PTSD and depression symptoms at 1 and 3 months post-trauma follow-up than those who were treated with placebo [16].”
From Efficacy of oxytocin administration early after psychotrauma in preventing the development of PTSD: study protocol of a randomized controlled trial (2014) · cites this paper as [16]
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“All previous findings of effective PTSD prevention were observed in participants with increased risk for PTSD [i.e., caused by perceived life-threat (3), peritraumatic dissociation (4), or subthreshold acute stress disorder (5,6)].”
From Intranasal Oxytocin to Prevent Posttraumatic Stress Disorder Symptoms: A Randomized Controlled Trial in Emergency Department Patients (2017) · cites this paper as [4]
In the citing paper
“Previously, hydrocortisone (4,5) and prolonged exposure (3) initiated within 12 hours posttrauma in ED patients, and brief cognitive behavioral therapy within the first weeks posttrauma in patients with acute stress disorder (6), were found to reduce subsequent PTSD symptom severity.”
From Intranasal Oxytocin to Prevent Posttraumatic Stress Disorder Symptoms: A Randomized Controlled Trial in Emergency Department Patients (2017) · cites this paper as [4]
In the citing paper
“In addition, starting intranasal oxytocin treatments at the latest at day 10 post-trauma is considerably later than the timing of the only pharmacological intervention that has currently yielded promising preventive effects, i.e. hydrocortisone within the first 12 hours post-trauma [15,16].”
From Efficacy of oxytocin administration early after psychotrauma in preventing the development of PTSD: study protocol of a randomized controlled trial (2014) · cites this paper as [16]
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“Based on previous early intervention studies, recruiting ED patients for research purposes early after trauma exposures is feasible [10,15,16,60,98].”
From Efficacy of oxytocin administration early after psychotrauma in preventing the development of PTSD: study protocol of a randomized controlled trial (2014) · cites this paper as [16]
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“Further, stress-level doses of hydrocortisone reduce PTSD symptomtology in patients following traumatic experience (Aerni et al., 2004; Delahanty et al., 2013; Schelling et al., 2003, 2001, 1999; Weis et al., 2006; Zohar et al., 2011).”
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Metadata
- Authors
- Delahanty, D. L., Gabert-Quillen, C., Ostrowski, S. A., Nugent, N. R., Fischer, B., Morris, A., Pitman, R. K., Bon, J., & Fallon, W.
- Affiliations
- Kent State University (US)
- Akron Children's Hospital (US)
- Harvard University (US)
- Summa Health System (US)
- Corresponding author
- Delahanty, Douglas L.
- Venue
- CNS Spectrums
- Publisher
- Cambridge University Press (CUP)
- Published
- 2013-04
- Volume
- 18
- Issue
- 2
- Pages
- 103-111
- ISSN
- 1092-8529 (ISSN-L)
- 2165-6509
- PMC
- PMC5981864
- OpenAlex
- W2165080151
- Cited by
- 115
- References
- 60
- Citations by year
- 2026: 7 · 2025: 5 · 2024: 6 · 2023: 6 · 2022: 11 · 2021: 9 · 2020: 8 · 2019: 12 · 2018: 8 · 2017: 7 · 2016: 9 · 2015: 13 · 2014: 10 · 2013: 2
- FWCI
- 12.60
- Type
- journal article
- Language
- en
- Open access
- green
- www.ncbi.nlm.nih.gov
- Locations
- CNS Spectrums (publishedVersion)
- PubMed (publishedVersion)
- PubMed Central (acceptedVersion)
- Funders
- National Institute of Mental Health (K01MH087240, R34MH073014)
- Topics
- Social Sciences › Psychology › Clinical Psychology › Posttraumatic Stress Disorder Research
- Life Sciences › Neuroscience › Behavioral Neuroscience › Stress Responses and Cortisol
- Health Sciences › Medicine › Clinical Neurology › Traumatic Brain Injury Research
- Keywords
- cortisol, post-traumatic stress disorder, PTSD prevention, trauma patients, low-dose corticosteroids, depression, health-related quality of life, acute injuries
- MeSH terms
- Adult, Double-Blind Method, Female, Humans, Hydrocortisone, Male, Middle Aged, Risk Factors, Stress Disorders, Post-Traumatic, Anti-Anxiety Agents, Treatment Outcome
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