Citation

Jaramillo S, Suffoletto B, Callaway C, Pacella-LaBarbara M. Acad. Emerg. Med. 2019; ePub(ePub): ePub.

Affiliation

Department of Emergency Medicine, University of Pittsburgh School of Medicine, Pittsburgh, PA, USA.

Copyright

(Copyright © 2019, Society for Academic Emergency Medicine, Publisher John Wiley and Sons)

DOI

10.1111/acem.13816

PMID

31179590

Abstract

BACKGROUND: Despite the risk of developing posttraumatic stress disorder (PTSD) and associated comorbidities after physical injury, few Emergency Departments (ED) in the United States screen for the presence of psychological symptoms and conditions. Barriers to systematic screening could be overcome by using a tool that is both comprehensive yet brief. This study aimed to determine 1) the feasibility of screening for posttraumatic sequelae among adults with minor injury in the ED, and 2) the relationship between ED screening and later psychological symptoms and poor quality of life (QOL) at 6 weeks post-injury.

METHODS: In the EDs of two Level 1 trauma centers, we enrolled injured patients (n = 149) who reported serious injury and/or life threat in the past 24 hours. Subjects completed the Posttraumatic Adjustment Scale (PAS) to screen for PTSD and depression in the ED, and 6 weeks later they completed assessments for symptoms of PTSD, depression, and Trauma-Specific QOL (T-QoL).

RESULTS: Our retained sample at 6 weeks was 84 adults (51.2% male; M age = 33); 38% screened positive (+) for PTSD, and 76% screened positive for depression in the ED. Controlling for age, hospital admission, and ED pain score, regression analyses revealed that a (+) ED screen for both PTSD and depression was significantly associated with 6 weeks PTSD (p = 0.027, 95% confidence interval [CI] = 0.92-15.14) and depressive symptoms (p = 0.001, 95% CI = 2.20-7.74), respectively. Further, a (+) ED screen for depression (p = 0.043, 95% CI= -16.66 to -0.27) and PTSD (p = 0.015, 95% CI = -20.35 to -2.24) was significantly associated with lower T-QoL.

CONCLUSIONS: These results suggest that it is feasible to identify patients at risk for post-injury sequelae in the ED; screening for mental health risk may identify patients in need of early intervention and further monitoring. This article is protected by copyright. All rights reserved.

This article is protected by copyright. All rights reserved.

Language: en

Keywords

Posttraumatic stress disorder; depression; emergency department; quality of life; screening