Prevalence and Treatment of Depression and Posttraumatic Stress Disorder among Trauma Patients with Non-neurological Injuries

Background Psychological impairment among injury survivors is well documented. Little is known about the prevalence of treatment of psychological impairment, however. We aimed to determine the proportion of injury survivors treated for depression and post-traumatic stress disorder (PTSD) in the year after injury as well as to determine potential barriers to treatment. Methods Adults (18 and over) admitted to a Level I trauma center with an injury severity score (ISS) greater than 10, but without traumatic brain injury or spinal cord injury were eligible for study inclusion. The Center for Epidemiological Studies-Depression (CES-D) and PTSD CheckList – Civilian Versions (PCL-C) surveys were administered during the initial hospitalization and repeated at 1, 2, 4, and 12 months after injury. Patients were asked if they received treatment specifically for depression or PTSD at each follow-up. Factors associated with treatment were determined using multivariable logistic regression analysis. Results 500 injury survivors were enrolled in this prospective observational study. Of those, 68.4% of patients screened positive for depression at some point in the year after their injury (53.3% 1 month, 49.9% 2 month, 49.0% 4 month, and 50.2% 12 month). Only 22.2% of depressed patients reported receiving treatment for depression. 44.4% of patients screened positive for PTSD (26.6% 1 month, 27.8% 2 month, 29.8% 4 month, and 30.0% 12 month), but only 9.8% received treatment for PTSD. After adjusting for other factors, compared to commercial insurance status, self-pay insurance status was negatively associated with treatment for PTSD or depression (OR 0.44, 95% CI 0.21-0.95). Conclusion Depression and PTSD are common in non-neurotrauma patients in the year following injury. Greater collaboration between those caring for injury survivors and behavioral health experts may help improve psychological outcomes after injury. Level of Evidence Level III Prognostic Presented at the 48th Annual Meeting of the Western Trauma Association February 2018 in Whistler, BC Canada. Research reported in this publication was supported by the National Institute of General Medical Science of the National Institutes of Health under award number K23GM084427 as well as KL2TR001106, and UL1TR001108 from the National Institutes of Health, National Center for Advancing Translational Sciences, Clinical and Translational Sciences Award; the IUPUI Research Support Funds Grant; and the IU Grand Challenge Initiative. The content is solely the responsibility of the authors and does not necessarily represent the official views of the National Institutes of Health. Corresponding Author: Ben L. Zarzaur, MD, MPH, 720 Eskenazi Avenue, H-2 Room 431, Indianapolis, Indiana 46202. bzarzaur@iupui.edu. 317-880-5034 © 2018 Lippincott Williams & Wilkins, Inc.

from Emergency Medicine via xlomafota13 on Inoreader https://ift.tt/2xvE8Xd