1. Violent injury predicts poor psychological outcomes after traumatic injury in a hard-to-reach population: an observational cohort study
- Author
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Ania Korszun, Melanie Smuk, Kamaldeep Bhui, Iain Hutchison, and Emmylou Rahtz
- Subjects
Adult ,Male ,medicine.medical_specialty ,Adolescent ,Urban Population ,Epidemiology ,Population ,Poison control ,Hospital Anxiety and Depression Scale ,Stress Disorders, Post-Traumatic ,03 medical and health sciences ,Young Adult ,0302 clinical medicine ,Depression and mood disorders ,Surveys and Questionnaires ,Injury prevention ,London ,Medicine ,Humans ,030212 general & internal medicine ,Prospective Studies ,education ,Psychiatry ,Aged ,Psychiatric Status Rating Scales ,education.field_of_study ,business.industry ,Depression ,Research ,030208 emergency & critical care medicine ,General Medicine ,Middle Aged ,Acute Stress Disorder ,Distress ,Traumatic injury ,Mental Health ,Orthopaedic and taruma surgery ,Physical Abuse ,Accidents ,Emergency Medicine ,Wounds and Injuries ,Female ,business ,Psychosocial - 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.
- Published
- 2017