On Injuries And Post-traumatic Stress Disorder

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One thing that never ceases to amaze me is the lack of general psychological knowledge in the medical profession. When you are aiding in the healing process of a person, it is essential to have a handle on basic psychology, even if it is by self-education. It can be quite dehumanizing to focus on a medical career from the pathological-body point of view. For instance, consider a person that has been severely injured after a car accident. All the patient’s injuries are surgically correctable, and he can be brought back to normal health through physiotherapy and the like, so he is considered “fixed” and can continue with his life as if nothing happened… But not quite, as we can see today in the news:

Post-traumatic Stress Disorder Common Among Injured Patients


Sep. 15, 2008

Suffering a traumatic injury can have serious and long-lasting implications for a patient’s mental health, according to the largest-ever U.S. study evaluating the impact of traumatic injury.

Researchers from the Harborview Injury Prevention and Research Center, the University of Washington, and the John Hopkins Bloomberg School of Public Health found that post-traumatic stress disorder and depression were very common among patients assessed one year after suffering a serious injury. They also found that injured patients diagnosed with PTSD or depression were six times more likely to not have returned to work in the year following the injury.

The study followed 2707 injured patients from 69 hospitals across the country, and found 20.7% had post-traumatic stress disorder and 6.6% had depression one year after the injury. Both disorders were independently associated with significant impairments across all functional outcomes: activities of daily living, health status, and the return to usual activities, including work. Patients who had one disorder were three times less likely to be working one year after injury, and patients with both disorders were five to six times less likely to have returned to work.

The findings have important implications for U.S. acute care hospitals. Smaller scale investigations in acute care medical settings suggest that evidence-based psychotherapy and collaborative care interventions can reduce the symptoms of PTSD and related conditions among injured trauma survivors.

“This study highlights the importance of ongoing studies of PTSD and depression screening, and intervention procedures for injured patients treated in acute care hospitals nationwide,” said Douglas Zatzick, M.D., principal investigator and a psychiatrist at the University of Washington. “If studies of PTSD and depression establish the effectiveness of screening and intervention procedures, American College of Surgeons policy requirements similar to the recent mandate for alcohol screening and brief intervention could be considered.” The American College of Surgeons now requires that level I trauma centers must have on-site alcohol screening and brief intervention services as a requisite for trauma center accreditation.

The study is published in the September issue of the Annals of Surgery. Research funding was provided by the National Center for Injury Prevention and Control and the Centers for Disease Control and Prevention, the National Institute of Aging, and the National Institute of Mental Health. Harborview Injury Prevention & Research Center, one of the nation’s leading institutions dedicated to injury prevention and trauma research, is affiliated with the University of Washington, and Harborview Medical Center in Seattle.

I once saw a doctor giving advice to a person that had undergone an amputation after a severe motorcycle accident. The advice basically consisted of, “You’re dismissed today from the hospital, but don’t get back on a motorcycle!” Laughs were heard all around. Ok, maybe I’m too serious here – after all, emergency room humor is indeed needed every now then for “survival” and “coping” purposes – but it really was not funny at all from the point of view of the patient! I suggest seeking psychological support without hesitation. We’re not merely bodies! Most doctors never send their patients to any kind of psychological therapy or support, so you can take the initiative and ask in order to ease the impact of trauma.

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