Over half of all patients who experience orthopedic trauma develop post-traumatic stress disorder

The first study involving people who have experienced orthopedic trauma suggests that over half of all such patients meet diagnostic criteria for post-traumatic stress disorder, according to a presentation at the 70th Annual Meeting of the American Academy of Orthopedic Surgeons.

"Any illness or psychological disturbance that has a substantial negative impact on outcome after trauma cannot be ignored. In some cases, post-traumatic psychological illness may have a stronger effect on outcome than the severity of the injury itself," said Adam J. Starr, M.D., principal investigator of the American study.

The current study was developed because serious extremity injury was known to have a highly negative impact on quality of life, but no research had been done to assess prevalence of post-traumatic stress disorder in orthopedic patients. The questionnaire used in the study was the Revised Civilian Mississippi Scale for Post-Traumatic Stress Disorder, a self-report questionnaire that is widely used by American mental-health professionals and is based on diagnostic criteria for the disorder. The investigative team created one additional question asking whether emotional aspects caused by the injury were more difficult to cope with than the physical problems.

Researchers evaluated 330 trauma follow-up patients with various injury histories, including motor vehicle collision, vehicle-pedestrian collision, motorcycle collision, crush injuries, horseback riding injuries, and gunshot wounds. The average injury severity score was 8.3 on a scale with a range of 1 to 36. The average time elapsed since injury was14 months.

The research team found that 52 percent of the orthopedic trauma patients who answered the questionnaire met the diagnostic criteria for the disorder. These patients also had significantly higher injury severity scores. Another trend was that increased elapsed time since injury was associated with increased risk for post-traumatic stress disorder rather than with gradually decreasing risk.


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