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Type: Journal article
Title: The long-term psychiatric sequelae of severe injury: a 6-year follow-up study
Author: O'Donnell, M.
Alkemade, N.
Creamer, M.
McFarlane, A.
Silove, D.
Bryant, R.
Forbes, D.
Citation: Journal of Clinical Psychiatry, 2016; 77(4):e473-e479
Publisher: Physicians Postgraduate Press, Inc.
Issue Date: 2016
ISSN: 0160-6689
Statement of
Meaghan L. O, Donnell, Nathan Alkemade, Mark C. Creamer, Alexander C. McFarlane, Derrick Silove, Richard A. Bryant and David Forbes
Abstract: Objective: The impact of mental health on disease burden associated with injury represents a major public health issue, yet almost no information is available on the associated long-term mental health outcomes. The primary aim of this study was to assess the psychiatric outcomes 6 years after a severe injury and their subsequent impact on long-term disability. The secondary aim was to investigate the relationship between a mild traumatic brain injury (mTBI) and long-term psychiatric disorder and its impact on disability. Methods: From April 2004 to February 2006, randomly selected injury patients admitted to 4 hospitals across Australia were assessed during hospitalization and at 72 months after trauma (N = 592). Injury characteristics, the presence of an mTBI (ICD-9 criteria), and previous psychiatric history were assessed during hospitalization. Structured clinical interviews for psychiatric disorders (DSM-IV and DSM-5) and a self-report measure of disability (WHODAS II) were administered at 72 months. Results: At 72 months after a severe injury, 28% of patients met criteria for at least 1 psychiatric disorder, with 45% of those presenting with comorbid diagnoses. The most prevalent psychiatric disorder was a major depressive episode (11%) followed by substance use disorder (9%), agoraphobia (9%), posttraumatic stress disorder (6%), and generalized anxiety disorder (6%). The presence of any psychiatric disorder was found to increase the risk for disability (P < .001, odds ratio = 6.04). An mTBI was found to increase the risk for having some anxiety disorders but not to increase disability by itself. Conclusions: The long-term psychiatric consequences of severe injury are substantial and represent a significant contributor to long-term disability. This study points to an important intersection between injury and psychiatric disorder as a leading contributor to disease burden and suggests this growing burden will impose new challenges on health systems.
Keywords: Humans
Brain Concussion
Substance-Related Disorders
Wounds and Injuries
Disability Evaluation
Risk Factors
Retrospective Studies
Follow-Up Studies
Mental Disorders
Anxiety Disorders
Stress Disorders, Post-Traumatic
Depressive Disorder, Major
Middle Aged
Young Adult
Rights: © Copyright 2016 Physicians Postgraduate Press, Inc.
DOI: 10.4088/JCP.14m09721
Grant ID:
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