The Effect of Postinjury Depression on Quality of Life following Minor Injury

Abstract

Purpose To describe quality of life (QoL) in the year following minor injury and to test the hypothesis that individuals with depression in the postinjury year experience lower QoL than do individuals with no depression. Design Prospective, longitudinal, cohort design. A total of 275 adults were randomly selected from injured patients presenting to an urban emergency department. Methods All participants underwent structured psychiatric diagnostic interviews immediately after injury and at 3, 6, and 12 months. The primary outcome, QoL, was measured using the Quality of Life Index. Covariates included demographics, injury status, preinjury functional status, preinjury social support, and anticipation of problems postdischarge. The General Estimating Equation was used to compare changes in QoL between participants with and without depression over 3, 6, and 12 months, adjusting for covariates. Results An 18.1% proportion (95% confidence interval [CI] 13.3, 22.9%) of the sample met criteria for a mood disorder in the postinjury year. The depressed group reported a QoL that was 4.2 points (95% CI 2.8–5.6) lower in the year postinjury compared with that of the nondepressed group. Conclusions Depression after minor injury negatively affects QoL even a full year postinjury. Clinical Relevance The findings of this study show that patients who have injuries that are treated and discharged from an emergency department can have significantly lower QoL in the year after that injury that may be attributed to postinjury depression. Nurses should provide anticipatory guidance to patients that they may experience feelings of sadness or being “blue,” and that if they do, they should seek care.

Psychological morbidity and health-related quality of life after injury: multicentre cohort study

“…A US study of injured adult ED attenders reported a significantly lower QoL (Quality of Life Index) in those with, than in those without, depression in the 12 months post-injury [21]. Injured adults admitted to a trauma centre in Norway with higher depression scores between 1 and 2 months post-injury had lower HRQoL (SF-36) 12 months post-injury [16].…”

“…Several studies have found psychological problems after injury can have a greater impact on quality of life than the physical injury [4, 10, 17, 18] and impairments to quality of life can persist after resolution of the psychological symptoms [19]. Few studies have focussed on the relationship between psychological morbidity and quality of life after injury amongst general injury populations, including those with minor and more major injuries [4, 16, 20, 21]. Identifying and managing psychological problems are recognised as an important component of UK post-injury care for major trauma [22] or for specific injuries such as burns [23], head injuries [24] or spinal cord injuries [25].…”

The effect of mental health on long-term health-related quality of life following a road traffic crash: Results from the UQ SuPPORT study

“…Work by Cole and colleagues found injured workers with high recovery expectations reported lower pain levels and higher QoL, compared to workers with low recovery expectations 18 . Other research has found greater social support predicts higher QoL post-injury 16 , and an indirect negative relationship between PTSD and social support in an RTC sample 19 . The relationship between pain and QoL has also been extensively studied in many populations.…”

“…A recent systematic review found PTSD to very strongly impair QoL in a variety of populations 13 , and specific to RTCs, researchers have found the presence of PTSD to predict poorer QoL at one year post-RTC 14 . In general injury cohorts, diagnosed depression was closely associated with reduced QoL 15,16 , as was high scores on the Hospital Page 7 of 37 A c c e p t e d M a n u s c r i p t 7 Anxiety and Depression Scale (HADS) 17 . There is a clear relationship between the presence of mental illness and reported QoL, however, while others have used scores on screening questionnaires as a measure of mental illness 7 , there has been no research to date which examines the relationship between QoL and mental health diagnosis in a RTC sample with predominately minor injuries.…”

Patients’ Experiences With Vehicle Collision to Inform the Development of Clinical Practice Guidelines: A Narrative Inquiry

“…A relationship can be improved if the health care provider offers explanations, choices, and anticipatory teaching about treatment options in a manner that is understood by the patient. 44 This is fundamental in alleviating a patient's uncertainty about recovery. The findings of our qualitative inquiry confirm the work of others who emphasized the importance of the patient-provider relationship.…”