Psychological distress and physical disability in patients sustaining severe injuries in road traffic crashes: Results from a one-year cohort study from three European countries

Papadakaki, Maria; Ferraro, Ottavia Eleonora; Orsi, Chiara; Otte, Dietmar; Tzamalouka, Georgia; von-der-Geest, Marco; Lajunen, Timo; Özkan, Türker; Morandi, Anna; Sarris, Markos; Pierrakos, George; Chliaoutakis, Joannes

doi:10.1016/j.injury.2016.11.011

Cited by 41 publications

(52 citation statements)

References 35 publications

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“…Rates of MDD and PTSD have been shown to be high up to 12 months post-MVC, with for example, almost 30% of people at risk of MDD after sustaining TBI or SCI [ 12 , 14 ]. Recent prospective research found 1 in 2 persons suffered elevated rates of depression and PTSD soon after a MVC and elevated rates were still present 12 months later [ 15 ]. In a systematic review, median occurrence of PTSD in people sustaining physical injury in a MVC was found to be around 30% 1 month post-MVC, with a declining trend at 12 months to 15% [ 13 ].…”

Section: Introductionmentioning

confidence: 99%

Prevalence and psychometric screening for the detection of major depressive disorder and post-traumatic stress disorder in adults injured in a motor vehicle crash who are engaged in compensation

et al. 2018

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BackgroundPhysical injury and psychological disorder following a motor vehicle crash (MVC) is a public health concern. The objective of this research was to determine rates of major depressive disorder (MDD) and post-traumatic stress disorder (PTSD) in adults with MVC-related injury engaged in compensation, and to determine the capacity (e.g. sensitivity and specificity) of two psychometric scales for estimating the presence of MDD and PTSD.MethodsParticipants included 109 adults with MVC-related injury engaged in compensation during 2015 to 2017, in Sydney, Australia. The mean time from MVC to baseline assessment was 11 weeks. Comprehensive assessment was conducted at baseline, and the Depression Anxiety Stress Scales (DASS-21) and the Impact of Event Scale-Revised (IES-R) were administered to determine probable MDD and PTSD. An online psychiatric interview, based on Diagnostic and Statistical Manual for Mental Disorders (DSM-5), was used to diagnose actual MDD and PTSD, acknowledged as gold standard diagnostic criteria. One-way multivariate analyses of variance established criterion validity of the DASS-21 and IES-R, and sensitivity and specificity analyses were conducted to determine the most sensitive cut-off points for detecting probable MDD and PTSD.ResultsSubstantial rates of MDD (53.2%) and PTSD (19.3%) were found. The DASS-21 and IES-R were shown to have excellent criterion validity for detecting MDD and PTSD in injured participants. A range of cut-off points were investigated and shown to have acceptable sensitivity and specificity for detecting MDD and PTSD in an injured population engaged in compensation. The preferred cut-off points based on this study are: to detect MDD, a DASS-21 total score of 30 and/or a DASS-21 depression score of 10; to detect PTSD, IES-R scores of 33–40 and/or a DASS-21 anxiety score of 7–8.ConclusionsMajor psychological disorder is prevalent following a MVC. Results suggest the DASS-21 and IES-R are suitable for use in clinical/compensation settings to detect probable MDD and PTSD soon after a MVC in physically injured people engaged in compensation. These results provide positive direction in the public health arena for improving mental health outcomes.Trial RegistrationClinical Trials registration number: ANZCTR - ACTRN12615000326594 (9th April 2015).

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Section: Introductionmentioning

confidence: 99%

Prevalence and psychometric screening for the detection of major depressive disorder and post-traumatic stress disorder in adults injured in a motor vehicle crash who are engaged in compensation

et al. 2018

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“…This suggests that changes to healthcare protocols and practices are warranted. For example, in accordance with previous research, directing additional resources such as screening and treating psychological conditions of claimants who are at higher risk 9 regardless of whether their psychological condition predated their MVC provides opportunity for reducing time and costs involved with compensation claims.…”

Section: Discussionmentioning

confidence: 61%

“… 3 8–10 Recent prospective research found that one in two persons suffered elevated rates of psychological distress (eg, depression) soon after the MVC and many of these continue to experience elevated distress 12 months after the MVC. 9 Factors such as more severe physical injury, older age and past negative emotional reactions to distress were associated with elevated psychological distress 12 months post-MVC. 9 For the purpose of this study, psychological distress is defined as an unpleasant mental condition perceived as disturbing and which can impede daily functioning, with mental symptoms including agitation, fatigue, confusion, loss of motivation and depressed mood.…”

Section: Introductionmentioning

confidence: 92%

“… 9 Factors such as more severe physical injury, older age and past negative emotional reactions to distress were associated with elevated psychological distress 12 months post-MVC. 9 For the purpose of this study, psychological distress is defined as an unpleasant mental condition perceived as disturbing and which can impede daily functioning, with mental symptoms including agitation, fatigue, confusion, loss of motivation and depressed mood.…”

Section: Introductionmentioning

confidence: 92%

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Psychological distress following a motor vehicle crash: evidence from a statewide retrospective study examining settlement times and costs of compensation claims

et al. 2017

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ObjectiveTo determine whether psychological distress associated with musculoskeletal injuries sustained in a motor vehicle crash (MVC), regardless of time of onset, impacts compensation outcomes such as claim settlement times and costs. Second, to identify factors routinely collected by insurance companies that contribute to psychological distress during the compensation process.DesignStatewide retrospective study.Data sourceAnalysis of the New South Wales statewide (Australia) injury register for MVC survivors who lodged a compensation claim from 2011 to 2013.Participants6341 adults who sustained a musculoskeletal injury and who settled a claim for injury after an MVC. Participants included those diagnosed with psychological distress (n=607) versus those not (n=5734).Main outcome measuresTime to settlement and total costs of claims, as well as socio-demographic and injury characteristics that may contribute to elevated psychological distress, such as socio-economic disadvantage, and injury severity.ResultsPsychological distress in those with a musculoskeletal injury was associated with significantly longer settlement times (an additional 17 weeks) and considerably higher costs (an additional $A41 575.00 or 4.3 times more expensive). Multivariate logistic regression analysis identified risk factors for psychological distress including being female, social disadvantage, unemployment prior to the claim, not being at fault in the MVC, requiring ambulance transportation and rehabilitation as part of recovery.ConclusionsResults provide compelling evidence that psychological distress has an adverse impact on people with musculoskeletal injury as they progress through compensation. Findings suggest that additional resources should be directed toward claimants who are at risk (eg, the socially disadvantaged or those unemployed prior to the claim), the major aim being to reduce risk of psychological distress, such as post-traumatic stress disorder, and associated risk of increased settlement times and claim costs. Prospective studies are now required that investigate treatment strategies for those at risk of psychological distress associated with an MVC.

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“…A thorough understanding of the transition of each condition and their associations over time is crucial to develop evidence-based, tailored, integrated interventions that may lead to improved recovery. [12] Depressive mood (DM) and post-traumatic stress (PTS) are very common mental health symptoms following an accident or injury [5,[13][14][15], however, most studies have investigated PTS rather than depression. If these DM and PTS symptoms remain elevated, there is an increased risks of disability [16][17][18] and progression to serious mental disorders (as per Diagnostic and Statistical Manual (DSM) of Mental Disorders criteria), like major depressive disorder (MDD), post-traumatic stress disorder (PTSD), panic disorder and generalized anxiety disorder [5,19].…”

Section: Introductionmentioning

confidence: 99%

Outcomes after traffic injury: mental health comorbidity and relationship with pain interference

Pozzato

Craig

Gopinath

et al. 2020

Preprint

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Background: Mental health symptoms, like depressive mood (DM) and post-traumatic stress (PTS), and pain interference (PI) with daily functioning often co-occur following traffic injury and their comorbidity can complicate recovery. This study aimed to map the course and overlapping trajectories of mental health symptoms, and associations with PI in a traffic injury population. Methods: In total, 2019 adults sustaining minor-to-moderate traffic injury were recruited within 28 days post-injury and assessed using phone interviews at 1, 6 and 12-months post-injury. Trajectories of DM, PTS and PI were established and relationships between DM, PTS and PI trajectories were explored using dual trajectory modelling. Bio-psychosocial predictors (e.g. pre-injury health, catastrophizing, acute distress, quality of life, social support) of mental health trajectories were investigated.Results: Up to five typical post-trauma trajectories were identified for DM, PTS and PI. Most people were in a resilient mental health trajectory (over 60%, DM or PTS), or in a chronic PI trajectory (almost 60%) 12 months post-injury. While recovery/resilient mental health trajectories were strongly interrelated (73.4% joint probability and >94% conditional probabilities), DM/PTS comorbidity in chronic trajectories was not straightforward, suggesting a possibly asymmetric relationship. That is, persistent DM was more likely associated with persistent PTS (90.4%), than vice versa (31.9%), with a 22.5% probability that persistent PTS was associated with none or milder depression (i.e. following a recovery/resilient DM trajectory). An asymmetrical relationship was also found between mental health and PI. The majority of those with persistent PI were likely to be in a recovery/resilient DM/PTS trajectory (almost 70%), but those in a non-resilient DM/PTS trajectory showed a high risk of persistent PI. Predictors of non-resilient mental health trajectories included poorer pre-injury health and social support, and shared factors like acute psychological distress and pain catastrophizing. Conclusions: Strong interrelations were confirmed between mental health symptoms and PI following traffic injury. However, persistent DM was more strongly linked to persistent PTS, than vice versa. Persistent PI was only linked with persistent DM/PTS in vulnerable subgroups. Early psychiatric/psychological interventions should target elevated psychological distress and negative appraisals in vulnerable individuals, to reduce long-term mental health morbidity/comorbidity and PI. Trial registration: ACTRN12613000889752.

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Psychological distress and physical disability in patients sustaining severe injuries in road traffic crashes: Results from a one-year cohort study from three European countries

Cited by 41 publications

References 35 publications

Prevalence and psychometric screening for the detection of major depressive disorder and post-traumatic stress disorder in adults injured in a motor vehicle crash who are engaged in compensation

Prevalence and psychometric screening for the detection of major depressive disorder and post-traumatic stress disorder in adults injured in a motor vehicle crash who are engaged in compensation

Psychological distress following a motor vehicle crash: evidence from a statewide retrospective study examining settlement times and costs of compensation claims

Outcomes after traffic injury: mental health comorbidity and relationship with pain interference

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