Maxillofacial trauma and psychiatric sequelae: post-traumatic stress disorder

Interest in the psychiatric consequences of trauma and the subsequent surgical intervention has been increasing steadily; therefore, the authors assessed the prevalence of acute symptoms of stress in patients who experienced a craniomaxillofacial injury. Fifty patients between the ages of 18 and 65 years were evaluated and assigned a score using the Injury Severity Scale (ISS). Within 48 hours of surgery (T0) and at 3 months after surgery (T1), the authors administered the Davidson Trauma Scale (DTS) to assess post-traumatic symptoms, Spielberger's State-Trait Anxiety Inventory (STAI) to assess symptoms of anxiety, and Zung's Self-rating Depression Scale (SDS) to assess depressive symptoms. Of the subjects, 44% (22 patients at T0) had acute symptoms of stress, and 26% (13 patients at T1) had post-traumatic stress symptoms. The statistical association between demographic variables was significant only for gender, especially for women. There was a significant correlation between the psychopathologic variables and trauma-specific symptoms at both T0 and T1; the same was true for the ISS at T0. Eight of the 13 patients with positive DTS results at 3 months had aesthetic and functional sequelae that might have served as reminders of the traumatic event. It is not only necessary to restitutio ad integrum the anatomy and function, but also to provide psychiatric support for patients experiencing psychiatric symptoms caused by traumatic events.