Risk Factors for Post-Injury Mental Health Problems

Abstract

Serious nonfatal physical injuries and burns are common occurrences that can have substantial implications for personal, social, and occupational functioning. Such injuries are frequently associated with significant mental health issues, and compromised quality of life and well-being. The purpose of this review is to summarize the current literature on physical, psychological, and social risk factors for mental health issues post-injury and to contextualize findings using Engel's biopsychosocial framework. We distinguish between pre-injury, injury-related, and post-injury risk factors for mental health problems. Female sex, history of mental health problems or trauma, type of injury, and level of pain are among the strong risk factors for mental health problems post-injury. We highlight inconsistent findings in the literature, identify directions for future research, and explore the implications of the risk factors identified for treatment and prevention.

Gender Differences in the Longitudinal Association between Work-Related Injury and Depression

“…Risk factors for post-injury depression in our study were consistent with the previous studies: female gender, injury severity, and higher levels of perceived stress or pain [14,34,35]. Although female workers tend to get depressed more after an injury, our subgroup analysis by gender revealed a relatively higher impact of occupational injury on depression in males.…”

Increased suicidal activity following major trauma

“…Depression was defined as one or more hospitalizations with a diagnosis for depressive disorder, affective psychoses, neurotic depression, or adjustment reaction (ICD-9-CM codes 296.2Y296. 8 , or one or more physician visits with a diagnosis for anxiety disorders (ICD-9-CM code 300) and one or more prescriptions for an antidepressant or mood stabilizer (Anatomical Therapeutic Chemical codes N03AB02, N03AB52, N03AF01, N05AN01, N06A). SUD was defined as one or more hospitalizations or physician visits with a diagnosis for alcohol or drug psychoses, alcohol or drug dependence, or nondependent abuse of drugs (ICD-9-CM codes 291, 292, 303Y305; ICD-10-CA codes F10YF19, F55).…”

“…5Y7 A recent psychosocial model has been proposed to help frame these interactions. 8 Recent studies have demonstrated an association between various traumatic events and suicidal behavior. 9Y11 A recent study in Swedish teenagers with an injury visiting an emergency department found an increased risk for subsequent premature death (1.44 standardized mortality ratio) compared with the reference population, with suicide accounting for 32% of these deaths.…”

Impacto psicológico das vítimas de trauma em reabilitação

“…A depressão pode afetar negativamente a recuperação e reabilitação da vítima de acidente por suprimir a função do sistema imunológico ou diminuir a motivação para participar dos programas de reabilitação (SAREEN et al, 2013).…”

“…Problemas de saúde mental, como depressão, podem ser uma reação a deficiências físicas que acompanham a lesão, dada às significativas perdas que podem ocorrer e a falta de controle sobre o próprio corpo e o ambiente (SAREEN et al, 2013). É destacado na literatura internacional que o apoio social tem fator preponderante na prevenção dos sintomas de depressão no pós-trauma (SAREEN et al, 2013). Segundo os autores o apoio emocional, a aceitação da família e dos amigos pode ajudar a amortecer o estresse associado ao trauma e facilitar a resiliência e o ajuste no pós-trauma.…”