抑郁症,焦虑症和创伤后应激障碍在上肢和下肢骨折后出现
Kevin Chen1, Kelly K Hynes2, Douglas Dirschl3
1The University of Chicago, Pritzker School of Medicine, Biological Sciences Learning Center, 924 E. 57th St., Ste. 104, Chicago, IL 60637, USA.
Injury
|December 3, 2023
概括
整形外伤显著增加患有严重抑郁症 (MDD),泛性焦虑症 (GAD) 和创伤后应激障碍 (PTSD) 的风险. 上肢骨折可能会带来更高的精神病风险,强调早期心理健康查的必要性.
科学领域:
- 整形外科手术 整形外科手术
- 精神病学是一个精神病学.
- 创伤护理 创伤护理
背景情况:
- 骨科创伤是精神疾病的已知危险因素,包括MDD,GAD和PTSD.
- 然而,这些创伤后病症的确切发病率和特定损伤的相关性仍然不清楚.
研究的目的:
- 调查骨科创伤 (上肢和下肢骨折) 与MDD,GAD和PTSD发病率在5年随访期间之间的联系.
- 确定伤害特征是否影响这些精神病诊断的发展风险.
主要方法:
- 一个大型的国家保险索赔数据库被用来识别上肢骨折 (UEF) 和下肢骨折 (LEF) 的患者队列.
- 包括接受选择性骨科手术的患者的对照组.
- 进行了包括多变量分析在内的后勤回归分析,以评估骨折类型和精神病诊断之间的关联,控制精神病史等并发症.
主要成果:
- 该研究确定了308,578名UEF患者和360,510名LEF患者.
- 与对照组相比,在UEF和LEF队列中观察到MDD (25-38%),GAD (10-14%),PTSD (4-7%) 的增加率.
- 特定的骨折模式显示出多种关联:孤立的UEF与MDD,GAD和PTSD相关;多个UEF与MDD和GAD相关;多个LEF与PTSD相关.
结论:
- 在骨科创伤后,精神疾病非常普遍.
- 骨科创伤是创伤后精神病诊断的独立预测因素,与PTSD和GAD的联系可能比MDD更强.
- 上肢骨折可能会增加精神疾病的风险,这强调了将心理健康查和支持纳入骨科护理途径的重要性.
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