Persistent disability is a risk factor for late-onset mental disorder after serious injury

Background: Most of what we know about the psychiatric consequences of injury is limited to the first year. Determining the prevalence of and risk factors for psychiatric morbidity beyond one year will aid service development and facilitate timely diagnosis and treatment. The aim of this prognostic...

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Bibliographic Details
Published in:Australian and New Zealand journal of psychiatry 2014-12, Vol.48 (12), p.1143-1149
Main Authors: Holmes, Alex CN, O’Donnell, Meaghan L, Williamson, Owen, Hogg, Malcolm, Arnold, Carolyn
Format: Article
Language:English
Subjects:
Accidental Falls
Accidents, Traffic
Adult
Biological and medical sciences
Female
General aspects
Humans
Injury Severity Score
Male
Medical sciences
Mental Disorders - diagnosis
Mental Disorders - epidemiology
Mental illness
Middle Aged
People with disabilities
Prevalence
Psychiatry
Psychology. Psychoanalysis. Psychiatry
Psychopathology. Psychiatry
Risk Factors
Wounds and Injuries - psychology
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Summary:Background: Most of what we know about the psychiatric consequences of injury is limited to the first year. Determining the prevalence of and risk factors for psychiatric morbidity beyond one year will aid service development and facilitate timely diagnosis and treatment. The aim of this prognostic study was to determine the prevalence of mental disorders in the three years following serious injury and to identify risk factors for the onset of new disorders after 1 year. Methods: Of 272 patients assessed in hospital following serious injury, 196 (72.1%) were reassessed at 3 years. Assessment involved gold standard semi-structured interviews for psychiatric diagnoses, risk factors for mental disorder, injury measures and pain scores. Results: More than a quarter of all patients were diagnosed with at least one mood or anxiety disorder at some stage during the three years following their injury. The most common diagnoses were major depression (20.0%), generalised anxiety disorder (6.7%) and panic disorder (6.7%). For a third of these patients, the disorder appeared after 12 months, for which persistent physical disability was an independent risk factor. Conclusion: Although there is a necessary focus on the early detection and treatment of mental disorders after injury, attention to later onset disorders is also required for those with persistent pain and physical disability.
ISSN:0004-8674
1440-1614
DOI:10.1177/0004867414533836