Many individuals who are hospitalized for a serious injury due to violence are at greater risk for developing post-injury depression and/or post-traumatic stress disorder (PTSD).
A new study finds that these post-injury mental health risks are even higher among patients whose injuries stem from a violent event or among those who had experienced previous life adversity.
Researchers from the University of Pennsylvania School of Nursing (Penn Nursing) observed more than 600 urban black men who had been hospitalized for severe injuries. The team followed the men for three months after hospital discharge to assess for mental health symptoms.
For the patients in the study, some of whom experienced previous trauma, childhood adversity, and neighborhood disadvantage, acute post-injury stress responses were found to be exacerbated. Almost one-half of the study participants met the diagnostic criteria for depression and/or PTSD at follow-up.
The researchers found that participants with violent injuries (as compared to those with non-violent injuries) had more severe post-injury mental health symptoms.
In addition, the study shows the importance of taking into consideration prior life experiences, such as adverse childhood experiences, neighborhood disadvantage, pre-injury health, and psychological resources in addition to acute stress responses to an injury event, in order to identify injured patients at greater risk for poor post-injury mental health outcomes.
“The intersection of prior trauma and adversity, prior exposure to challenging neighborhood disadvantage, and poorer preinjury health and functioning should not be overlooked in the midst of acute injury care when assessing for the risk of postinjury mental health symptoms,” said lead investigator Therese S. Richmond, Ph.D., CRNP, FAAN, the Andrea B. Laporte Professor of Nursing, and Associate Dean for Research & Innovation.
The new findings appear in the journal JAMA Surgery.
“This study takes a life-trajectory approach, helps inform potential points of intervention to improve outcomes, and adds to understanding both risk and protective factors across the life trajectory in an understudied group at high risk for injury,” said Richmond.
“We must integrate psychological care into the very essence of trauma care if we are to improve outcomes from serious injuries. Because symptoms develop after hospital discharge, further developing and using screening instruments designed to predict the future development of postinjury mental health problems is warranted to focus services on those patients at highest risk.”
However, although addressing the psychological effects of injury can improve health and reduce negative outcomes, a national survey shows that only seven percent of trauma centers incorporate routine screening for PTSD symptoms.
The new findings appear in the journal JAMA Surgery.
Source: University of Pennsylvania School of Nursing
Recent Comments