Depression, Anxiety, and posttraumatic Stress Disorder After Traumatic Injury: A Temporal Retrospective Cohort Study

Traumatic injury can precipitate mental health conditions, yet the scale and timeline of depression, anxiety, and posttraumatic stress disorder (PTSD) development remain unclear. We aimed to characterize the monthly incidence and prevalence of these conditions following traumatic injury.

We conducted a retrospective cohort study using the TriNetX Research Network. Adult patients with an emergency department or inpatient encounter in January 2019 were classified as injured (International Classification of Diseases, 10th Revision Codes S01-S99, T07, T14, T79) or noninjured (all other codes). Monthly incidence and prevalence of depression (F32, F33), anxiety (F41), and PTSD (F43.1) were measured and compared between injured and noninjured groups for the following year (α = 0.05). Patients with these diagnoses in the preceding year were excluded from incidence calculations.

A total of 924,243 patients (100,173 injured; 823,796 noninjured) from 93 healthcare organizations were included. Incidence rates of depression, anxiety, and PTSD peaked at 1 mo in both groups but were significantly higher in injured patients: incidence rate ratios were 1.96 for depression (95% confidence interval 1.81-2.14), 2.04 for anxiety (1.90-2.18), and 1.79 for PTSD (1.57-2.05). At 12 mo, injured patients had higher prevalence of depression (26.3% versus 15.3%), anxiety (28.6% versus 18.6%), and PTSD (7.5% versus 4.9%) (all P < 0.0001).

Using a large, representative dataset, we found increased incidence and prevalence of depression, anxiety, and PTSD in traumatically injured patients that persisted at 1 y. Our findings elucidate the temporal patterns of psychopathology development following injury, demonstrating the chronicity of these conditions.