The Long-Term Psychological Sequelae of Orofacial Injury

Glynn, Shirley M.; Shetty, Vivek

doi:10.1016/j.cpen.2011.08.002

Cited by 6 publications

(9 citation statements)

References 37 publications

(18 reference statements)

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“…Other workers have reported PTSD levels ranging from 10 to 44% for up to 9 months following facial injuries with high absolute levels of PTSD at the initial stages. 11,14,15 PTSD data in Indian population are limited with psychological consequences of road traffic accidents reported to range from 8.5 to 39%. 16 Undavalli et al 17 in a study of PTSD among post-road traffic accident patients requiring hospitalization in India observed a "three-hit" phenomenon, namely, hospital expenditure due to trauma; time away from work during hospitalization and recovery which results in loss of income; and finally, a reduction in performance due to PTSD which may lead to loss of work, which a road traffic accident victim experiences in the posttrauma period and these hits are significant factors resulting in a financial crisis and worsening of the psychological state.…”

Section: Discussionmentioning

confidence: 99%

“…However, it has been observed that staffs working within facial trauma units often fail to detect, document, and treat the psychological symptoms due to limited knowledge of the possible psychological sequelae. 15 In a survey among oral and maxillofacial surgeons, 95% of surgeons had experienced patients with posttraumatic psychological morbidities, with close to 60% disclosing a moderate or high level of relevant knowledge. 22 Despite such high numbers, only a quarter had access to intra-service psychological staff.…”

Section: Discussionmentioning

confidence: 99%

“…24 PTSD may also have implications on wound healing due to a chronic disturbance in homoeostasis which could result in prolonged postoperative pain and increased drug dependence. 15 Furthermore, delayed healing may also encourage harmful habits such as substance abuse and predispose to maladjustment.…”

Section: Discussionmentioning

confidence: 99%

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Psychological Consequences of Maxillofacial Trauma in the Indian Population: A Preliminary Study

Krishnan

Rajkumar

2018

Craniomaxillofacial Trauma & Reconstruction

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The aim of this article is to identify the prevalence of posttraumatic psychological symptoms following maxillofacial trauma among an Indian population sample and assess changes in these symptoms over a period of time. Forty-eight adult patients were assessed within 2 weeks of injury with two follow-up visits (4-6 weeks and 12-14 weeks). Patients were administered three self-reporting questionnaires in local language (GHQ-12; HADS; TSQ) on all occasions. Relevant sociodemographic and clinical data were obtained. Forty patients were included in the final analysis. Emotional distress was present in nine participants and five participants satisfied the TSQ criteria for a diagnosis of stress disorder. Anxiety and depression were observed in 10 and 4 patients, respectively. Characteristics associated with abnormal high scores included substance abuse, low education and income levels, facial scars, and complications needing additional intervention. These findings reveal the abnormal psychological response to maxillofacial trauma in immediate and follow-up periods. The use of such screening tools can be considered by the maxillofacial surgeon for early identification of psychological symptoms and referral to the psychiatrist.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

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Psychological Consequences of Maxillofacial Trauma in the Indian Population: A Preliminary Study

Krishnan

Rajkumar

2018

Craniomaxillofacial Trauma & Reconstruction

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“…These have been used successfully in other studies. 28 Although, in principle, surgical teams could administer psychological screening tools in outpatient clinics, our experience of running this research within a very busy maxillofacial clinic challenged the feasibility of this. Despite excellent support and engagement with the research, without a psychologist present, surgeons' capacity to administer psychological screening to participants was at best variable and at worst nonexistent.…”

Section: Discussionmentioning

confidence: 99%

“…Therefore, there is growing impetus to implement effective screening for psychological diffi culties within maxillofacial services and for coordinated pathways of mental health care to be defi ned that are integrated with physical recovery for these patients. 2,27 Although a growing body of research identifying unmet psychological need in maxillofacial trauma patients does exist, 28 there are limitations to most of these studies. Almost all are based on socioeconomically disadvantaged, urban North American populations.…”

Section: Introductionmentioning

confidence: 99%

Prevalence and predictive factors of psychological morbidity following facial injury: a prospective study of patients attending a maxillofacial outpatient clinic within a major UK city

Wilson

Heke

Holmes

et al. 2018

Dialogues in Clinical Neuroscience

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Adults presenting to maxillofacial surgery services are at high risk of psychological morbidity. This study examined the prevalence of depression, post-traumatic stress disorder (PTSD), anxiety, drug and alcohol use, and appearance-related distress among maxillofacial trauma outpatients over medium-term follow-up. It also explored socio-demographic and injury-related variables associated with psychological distress to inform targeted psychological screening protocols for maxillofacial trauma services. Significant associations were found between level of distress at time of injury and number of traumatic life events with levels of depression at 3 months. No significant associations were found between predictor variables and PTSD at 3 months, or with any psychiatric diagnosis at 6 months. The lack of evidence for an identifiable subgroup of patients who were at higher risk of psychological distress indicated that routine screening of all maxillofacial trauma outpatients should be offered in order to best respond to their mental health needs. The feasibility of the medical team facilitating this is challenging and should ideally be undertaken by psychologists integrated within the MDT. This study led to the funding of a clinical psychologist to provide collaborative care with the maxillofacial surgeons, resulting in brief assessment and treatment to over 600 patients in the first year of the service.

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Facial Fractures and the National Basketball Association: Epidemiology and Outcomes

et al. 2020

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Objectives/Hypothesis: To identify the epidemiology and impact of facial fractures on player performance and return to play (RTP) in the National Basketball Association (NBA). Study Design: Retrospective case-control series Methods: Fifty-three NBA players who sustained facial fractures between 1984 and 2018 were identified. Players with pre-and postinjury statistics were included in the performance analysis. A control group was matched by age, body mass index (BMI), position, NBA experience, and player efficiency rating. Fisher exact tests and Student t tests were performed to analyze player demographics and performance variables. Results: At the time of injury, the average player's age was 26.17 years, BMI was 24.80 kg/m 2 , and NBA experience was 4.97 years. Players missed an average of 3.77 games and 18.21 days prior to RTP. Forty-eight players (90.6%) did RTP the subsequent season, whereas 43 of those players (81.1%) met inclusion criteria for performance analysis. There was no significant change in performance between pre-and postinjury seasons. Players managed operatively missed significantly more games (8.15 vs. 1.85; P = .034) and days (51.08 vs. 5.53; P = .003) than players managed nonoperatively, whereas performance was not impacted. Average career length following facial fracture was significantly shorter compared to controls (5.14 vs. 6.42 years; P = .010) and a decrease in three-pointer percentage (P = .004) was observed. Conclusions: The majority of players who suffer facial fractures RTP in the NBA and do not experience significant decline in performance following injury. These results should aid physicians caring for basketball players at any level, and may help inform future guidelines for treatment and injury prevention.

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The Long-Term Psychological Sequelae of Orofacial Injury

Cited by 6 publications

References 37 publications

Psychological Consequences of Maxillofacial Trauma in the Indian Population: A Preliminary Study

Psychological Consequences of Maxillofacial Trauma in the Indian Population: A Preliminary Study

Prevalence and predictive factors of psychological morbidity following facial injury: a prospective study of patients attending a maxillofacial outpatient clinic within a major UK city

Facial Fractures and the National Basketball Association: Epidemiology and Outcomes

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