Purpose
To estimate the prevalence of posttraumatic stress disorder (PTSD) and depression
among hand-injured patients and assess the impact of these disorders on general health
status.
Methods
A total of 106 adult hand-injured patients (40 women, 66 men) with a mean age of 42
years (range, 18–79 years) participated. Patients with a chronic mental illness or
cognitive impairment were excluded. Psychological status was assessed using the Revised
Civilian Mississippi Scale for PTSD and the Beck Depression Inventory. General health
status was evaluated with the Short Form-36 health survey (SF-36). We obtained demographics
and injury characteristics from the patient medical records.
Results
Prominent mechanisms of injury included a fall (n = 38), traffic-related injuries
(n = 14), machine versus operator (n = 8), gunshot wounds (n = 6), and assault (n
= 6). Using the screening questionnaires, 32 persons qualified for PTSD and 19 for
depression. Sixteen patients met the criteria for both PTSD and depression. The association
between PTSD and depression was significant (p < .01). Patients with PTSD had significantly
lower scores than those who did not endorse items consistent with PTSD or depression
on the SF-36 subscales of role–emotional (p < .01), body pain (p = .013), social function
(p = .028), and mental health (p < .01). We found no significant differences between
groups for the subscales of role–physical (p = .289), general health (p = .147), vitality
(p = .496), and physical functioning (p = .476). Patients who had concurrent PTSD
and depression had significantly lower scores than patients who had neither PTSD nor
depression on all subscales (p < .05 for all) except role–physical (p = .135). We
found significant negative correlations between Beck Depression Inventory scores and
all of the SF-36 subscales (p < .05 for all).
Conclusions
In this study, nearly one third of hand-injured patients met diagnostic criteria for
PTSD, depression, or both, according to the thresholds of the instruments used to
measure these psychological aspects of illness. PTSD and depression had a negative
effect on general health status after hand injury. It may be important to consider
psychological status when caring for patients with hand injuries.
Type of study/level of evidence
Prognostic II.
Key words
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Article info
Publication history
Accepted:
November 11,
2008
Received:
December 5,
2007
Footnotes
No benefits in any form have been received or will be received related directly or indirectly to the subject of this article.
Identification
Copyright
© 2009 Published by Elsevier Inc.
