Dr. David B. Adams – Psychological Blog

Psychology of Illness, Pain, Anxiety and Depression

Classification: Catastrophic

Expect PTSD to be very common in orthopedic injury especially those involved in MVAs and falls.

_About half of patients who have an orthopedic traumatic injury go on to develop posttraumatic stress disorder (PTSD), according to a report in the June, 2004, issue of The Journal of Bone and Joint Surgery.

“If you take care of orthopedic trauma patients, you’re going to encounter PTSD,” Dr. Adam J. Starr from University of Texas Southwestern Medical Center, Dallas, Texas told Reuters Health.

Contrary to the researchers’ expectations, the risk of PTSD seemed to increase with more elapsed time since the injury.

The prevalence of PTSD was higher among patients injured in motor vehicle-pedestrian collision (65%) or in motor-vehicle collision (57%) than among patients injured in a fall (43%), the results indicate.

The best individual predictor of PTSD was a positive response to the item, “The emotional problems caused by the injury have been more difficult than the physical problems,” the researchers note, though even this response was only a fair predictor of the presence of PTSD.

“We know from research in other disciplines that PTSD has a profound negative impact on outcome,” Dr. Starr said. “We think (although we haven’t proven) that treatment can lessen symptoms of PTSD which arises after civilian trauma.”

“Now that we’ve found that PTSD is common after orthopedic trauma, the question is, can we do anything to lessen the symptoms or lessen the prevalence of the illness? “We plan to compare the rate of PTSD, depression, and anxiety among orthopedic trauma patients who get cognitive behavioral therapy (CBT) to a similar group who get our current standard of care, which is no psychological treatment.”

J Bone Joint Surg 2004;86:1115-1121.

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