Competing interests declared: early interventions and long-term psychological outcomes

Survivors of motor vehicle accidents and/or survivors of critical care unit admission are at increased risk of developing post-traumatic reactions such as post-traumatic stress disorder, depression and anxiety. Examining the possible risk factors for the development of these disorders must consider pre-traumatic, peri-traumatic and post-traumatic factors and must do so across domains relating to the trauma, the person and their circumstances. The present study has found propofol administration in the first 72 hours post motor vehicle accident to confer a higher risk for full or partial post-traumatic stress disorder at 6 months. This study highlights concerns that treatment needed acutely post injury may impact adversely on long-term outcome, albeit in a different domain-the psychological.