Prospective Evaluation of Posttraumatic Stress Disorder in Injured Patients With and Without Orthopaedic Injury

Warren, Ann Marie; Jones, Alan L.; Bennett, Monica; Solis, Jaicus; Reynolds, Megan; Rainey, Evan Elizabeth; Viere, Grace; Foreman, Michael L.

doi:10.1097/bot.0000000000000623

Cited by 24 publications

(23 citation statements)

References 23 publications

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“…Additionally, although the current analytic strategy of dichotomizing the PTSD and depression scores into positive or negative screens is consistent with recommendations and previous work (Kroenke et al., ; Powers et al., ; Prins et al., ; Roden‐Foreman et al., ; Warren et al., , ; Warren Jones, et al., ; Warren, Reynolds, et al., ), future studies should replicate these findings with longer dimensional measures as well. Finally, further investigation is needed into the relationship between growth and distress.…”

Section: Discussionsupporting

confidence: 76%

“…Data from this study were part of a prospective longitudinal study of patients in an urban Level I trauma center in the Southwest United States (Agtarap, Scott, Warren, & Trost, ; Powers et al., ; Rainey et al., ; Roden‐Foreman et al., ; Trost et al., ; Warren et al., ; Warren et al., ; Warren, Jones, et al., ; Warren, Reynolds, et al., ). Participants were patients 18 years of age and older who were admitted to the trauma service for at least 24 hours with a traumatic injury, as defined by International Classification of Diseases 9th revision coding.…”

Section: Methodsmentioning

confidence: 99%

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Posttraumatic growth in a heterogeneous sample of traumatically injured patients 1 year postinjury

et al. 2017

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Section: Discussionsupporting

confidence: 76%

Section: Methodsmentioning

confidence: 99%

Posttraumatic growth in a heterogeneous sample of traumatically injured patients 1 year postinjury

et al. 2017

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“…Means and standard deviations on the MPQ-SF, PHQ-9 and PDI were similar (within one standard deviation) to those that have been reported in previous research on work-disabled individuals with comorbid pain and depression [41,42]. Based on scores on the MPQ-SF and the PHQ-9, the study sample would be characterized as experiencing chronic pain of moderate severity, with moderately severe symptoms of depression at the time of admission.…”

Section: Sample Characteristicssupporting

confidence: 68%

Risk-Targeted Behavioral Activation for the Management of Work-Disability Associated with Co-Morbid Pain and Depression: A Feasibility Study

Sullivan

Wideman

Gauthier³

et al. 2022

Preprint

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Purpose The purpose of the present study was to conduct a preliminary evaluation the feasibility and impact of a risk-targeted behavioral activation intervention for work-disabled individuals with co-morbid pain and depression. Methods The design of the study was a single arm non-randomized trial. The sample consisted of 66 work-disabled individuals with co-morbid pain and depression. The treatment program consisted of a 10-week standardized behavioral activation intervention supplemented by techniques to target two psychosocial risk-factors for delayed recovery, namely, catastrophic thinking and perceptions of injustice. Measures of pain severity, depression, catastrophic thinking, perceived injustice and self-reported disability were completed pre-, mid-, and post-treatment. Satisfaction with treatment was assessed at post-treatment. Return to work was assessed at 6-month follow-up. Results The drop-out rate was 18%. At treatment termination, 91% of participants indicated that they were ‘very’ or ‘completely’ satisfied with their involvement in the treatment program. Significant reductions in pain (d = .71), depression (d = .86), catastrophic thinking (d = 1.1) and perceived injustice (d = 1.0) were observed through the course of treatment. In multivariate analyses, treatment-related reductions in depression, catastrophic thinking, perceived injustice, but not pain, contributed significant unique variance to the prediction of return-to-work outcomes. Conclusions Risk-targeted behavioral activation was found to be an acceptable and effective intervention for work-disabled individuals with co-morbid pain and depression. The findings suggest that interventions targeting psychosocial risk factors for pain and depression might contribute to more positive recovery outcomes in work-disabled individuals with co-morbid pain and depression.

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“…Failure to provide adequate relief from pain can result in prolonged recovery, post-traumatic stress, and delayed return to functionality. [18][19][20][21][22] At the same time, exposure to opioids has been associated with future opioid misuse. 4,23 This poses a great challenge for providers in managing both short-and long-term welfare of patients.…”

Section: Discussionmentioning

confidence: 99%

“…[8][9][10] Many of these children experience moderate to severe pain after trauma, and opioids are one way that pain is treated. [11][12][13][14][15][16][17] Inadequately managed pain can lead to significant long-term consequences, such as post-traumatic stress and substance abuse 7,[18][19][20][21][22] ; however, early exposure to opioids has also been linked to similar outcomes. 4,23,24 Opioids are often first-line treatment for moderate and acute pain after trauma, yet many trauma centers lack clear guidelines for when opioids are indicated in the pediatric trauma population and for the maximum cumulative amount of opioid to administer to pediatric patients.…”

mentioning

confidence: 99%

Who Hurts More? A Multicenter Prospective Study of In-Hospital Opioid Use in Pediatric Trauma Patients in the Midwest

Peláez

Davis

Spilman

et al. 2019

Journal of the American College of Surgeons

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BACKGROUND: Despite increased national attention on misuse of prescription and nonprescription opioids for adolescents and children, little is known about opioid use in a pediatric population during hospitalization for injury. The purpose of this investigation is to describe opioid administration and magnitude of opioid exposure in the first 48 hours of hospitalization in a pediatric trauma population. STUDY DESIGN: This is a secondary analysis of data collected for a randomized, prospective intervention study at 4 Midwestern children's trauma centers. Participants included children ages 10 to 17 years old, admitted to the hospital for unintentional injury. Descriptive statistics and multivariable modeling were used to characterize demographic factors and measure prevalence and magnitude of opioid use within the first 48 hours of hospitalization. RESULTS: Among 299 participants, 82% received at least 1 opioid administration. Children had increased odds of receiving an opioid (odds ratio [OR] 4.25; 95% CI 2.16 to 8.35) for every log increase of Injury Severity Scores (ISS), yet the majority of children with minor injury (61%) also received an opioid. Children with fractures and older children had higher odds of receiving an opioid. Amount of opioid, expressed as morphine milligrams equivalent (MME), significantly increased with child age, ISS, and fracture. CONCLUSIONS: Most pediatric trauma patients received an opioid in the first 48 hours of hospitalization, although prevalence and exposure varied by age, injury, and acuity. Aggressive pain management can be appropriate for injured pediatric patients; however, study results indicate areas for improvement, specifically for children with minor injuries and those receiving excessive opioid amounts.

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Prospective Evaluation of Posttraumatic Stress Disorder in Injured Patients With and Without Orthopaedic Injury

Abstract: Prognostic Level I. See Instructions for Authors for a complete description of levels of evidence.

Cited by 24 publications

References 23 publications

Posttraumatic growth in a heterogeneous sample of traumatically injured patients 1 year postinjury

Posttraumatic growth in a heterogeneous sample of traumatically injured patients 1 year postinjury

Risk-Targeted Behavioral Activation for the Management of Work-Disability Associated with Co-Morbid Pain and Depression: A Feasibility Study

Who Hurts More? A Multicenter Prospective Study of In-Hospital Opioid Use in Pediatric Trauma Patients in the Midwest

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