Bone-Breaking Accidents Leave Mental Scar

People who suffer a severe traumatic injury may be left with more than broken bones to mend. Orthopedic surgeons have found that about half of such patients go on to develop posttraumatic stress disorder (PTSD), a condition more often thought of as afflicting combat veterans.

People who suffer a severe traumatic injury may be left with more than broken bones to mend. Orthopedic surgeons have found that about half of such patients go on to develop posttraumatic stress disorder (PTSD), a condition more often thought of as afflicting combat veterans. One of the hallmarks of PTSD is recurrent flashbacks of traumatic events, during which people relive the experience in vivid images. Other common symptoms of PTSD include anxiety, depression, insomnia, jumpiness and irritability. “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. Starr and his colleagues administered a standard PTSD questionnaire to 580 patients who had sustained trauma involving bone damage. According to the team’s report in The Journal of Bone and Joint Surgery, 51 percent of the subjects qualified for a diagnosis of PTSD. Contrary to the researchers’ expectations, the risk of PTSD seemed to increase with more elapsed time since the injury. They also found that the prevalence of PTSD was higher among people injured in automobile accidents involving a pedestrian (65 percent) or in car collisions (57 percent) than among patients injured in a fall (43 percent). The best individual indicator of PTSD was a positive response to the questionnaire item, “The emotional problems caused by the injury have been more difficult than the physical problems,” the researchers note. “We know from research in other disciplines that PTSD has a profound negative impact on outcome,” Starr said. Now the question is, “Can we do anything to lessen the symptoms or lessen the prevalence of the illness?” Starr said. “Nobody knows, so we’re going to try.” His group plans a clinical trial “comparing the rate of PTSD, depression, and anxiety among orthopedic trauma patients who get cognitive behavioral therapy to a similar group who get our current standard of care, which is no psychological treatment.” (Source: Reuters Health, Journal of Bone and Joint Surgery, June 2004)