Citation

Rahtz E, Bhui K, Smuk M, Hutchison I, Korszun A. BMJ Open 2017; 7(5): e014712.

Affiliation

Centre for Psychiatry, Barts and The London School of Medicine and Dentistry, London, UK.

Copyright

(Copyright © 2017, BMJ Publishing Group)

DOI

10.1136/bmjopen-2016-014712

PMID

28559457

Abstract

BACKGROUND: People who experience physical trauma face a range of psychosocial outcomes. These may be overlooked by busy clinicians. While some risk factors are understood, understanding of the psychological effects of violent injury remains limited, particularly in UK settings. This study compared psychological outcomes following interpersonal violence and accidental injury, including the persistence of psychological distress.

METHODS: A questionnaire survey was carried out at two time points of patients admitted to a large teaching hospital in London between July 2012 and April 2014. Participants were consecutive adult patients admitted to the Royal London Hospital with traumatic injuries, with 219 participants at baseline. Follow-up survey was 8  months later (n=109). Standardised measures assessed post-traumatic stress symptoms (PTSS) (Acute Stress Disorder Scale and PTSD Checklist) and depressive symptoms (Hospital Anxiety and Depression Scale).

RESULTS: PTSS and depressive symptoms affected 27% and 33%, respectively, at baseline. At 8  months, 27% and 31% reported these symptoms for PTSS and depressive symptoms, respectively. The repeated measures were assessed with multilevel models: after adjusting for demographic factors, patients with violent injury showed more PTSS (OR 6.27, 95% CI 1.90 to 20.66) and depressive symptoms (OR 3.12, 95% CI 1.08 to 8.99).

CONCLUSIONS: There were high levels of psychological distress among traumatic injury patients. Violent injuries were associated with an increased risk of both post-traumatic and depressive symptoms. People vulnerable to distress would benefit from psychological support, and hospital admission provides a unique opportunity to engage hard-to-reach groups in interventions.

© Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2017. All rights reserved. No commercial use is permitted unless otherwise expressly granted.

Language: en

Keywords

Depression and mood disorders; Mental health; Orthopaedic and taruma surgery; Psychiatry