Centre for Emotional Health, Department of Psychology, Macquarie University, Sydney, NSW, Australia.
Department of Psychology, Macquarie University, Sydney, NSW, Australia.
Stress Health. 2018 Oct;34(4):545-551. doi: 10.1002/smi.2815. Epub 2018 Jun 1.
The aim of this study was to investigate the influence of injury site and severity as predictors of mental health outcomes in the initial 12 months following traumatic injury. Using a multisite, longitudinal study, participants with a traumatic physical injury (N = 1,098) were assessed during hospital admission and followed up at 3 months (N = 932, 86%) and at 12 months (N = 715, 71%). Injury site was measured using the Abbreviated Injury Scale 90, and objective injury severity was measured using the Injury Severity Score. Participants also completed the Hospital Anxiety and Depression Scale and the Clinician Administered Post-traumatic Stress Disorder (PTSD) Scale. A random intercept mixed modelling analysis was conducted to evaluate the effects of site and severity of injury in relation to anxiety, PTSD, and depressive symptoms. Injury severity, as well as head and facial injuries, was predictive of elevated PTSD symptoms, and external injuries were associated with both PTSD and depression severity. In contrast, lower extremity injuries were associated with depressive and anxiety symptoms. The findings suggest that visible injuries are predictive of reduced mental health, particularly PTSD following traumatic injury. This has clinical implications for further advancing the screening for vulnerable injured trauma survivors at risk of chronic psychopathology.
本研究旨在探讨创伤后最初 12 个月内损伤部位和严重程度作为心理健康结局预测因素的影响。使用多地点、纵向研究，对 1098 名有创伤性身体损伤的参与者在住院期间进行评估，并在 3 个月（932 名，86%）和 12 个月（715 名，71%）时进行随访。使用 90 节损伤严重度量表测量损伤部位，使用损伤严重度评分测量客观损伤严重程度。参与者还完成了医院焦虑和抑郁量表以及临床医生管理的创伤后应激障碍（PTSD）量表。进行随机截距混合模型分析，以评估损伤部位和严重程度与焦虑、PTSD 和抑郁症状的关系。损伤严重程度以及头部和面部损伤与 PTSD 症状升高有关，外部损伤与 PTSD 和抑郁严重程度有关。相比之下，下肢损伤与抑郁和焦虑症状有关。研究结果表明，可见的损伤与心理健康受损有关，尤其是创伤后 PTSD。这对进一步推进对有慢性精神病理风险的易受伤创伤幸存者进行脆弱性筛查具有临床意义。
