Depression, trauma stress linked to physical complaints
Trauma victims who showed immediate signs of both depression and post-traumatic stress disorder are more likely to have psychosomatic ailments a year later, according to a new study.
The combination of both afflictions increases the incidence of somatic complaints, although this is not the case for either condition standing alone, say Douglas F. Zatzick, M.D., and colleagues from the University of Washington School of Medicine. Psychosomatic symptoms are physical complaints that cannot be medically explained.
The research findings appear in the November-December issue of the journal Psychosomatics.
Each year, about 2.6 million Americans require hospitalization after suffering traumatic physical injuries. Between 10 percent and 40 percent experience post-traumatic stress disorder (PTSD) in the year following injury, says Zatzick.
Zatzick and colleagues interviewed 73 randomly selected patients who agreed to be tested. The patients were hospitalized after emergency trauma surgery for intentional and unintentional injuries. Researchers tested them for physical symptoms, post-traumatic stress symptoms and depressive symptoms.
They also recorded the severity of injuries, the part of the body injured and other medical conditions that might have affected recovery.
While in the surgical ward, 31 percent of the patients scored high enough for a PTSD diagnosis and 42 percent had high depressive scores. A year later, those patients who had both higher depression and higher PTSD reported significantly higher levels of physical distress that could not be attributed to medical conditions. Women were also more likely than men to report such symptoms.
These patients also had used the health care system heavily in the subsequent 12 months but less often for their psychological well-being.
Knowing which patients had symptoms of PTSD and depression in the inpatient surgical unit and other acute care settings such as the emergency room might stimulate treatment and lessen the occurrence of future psychosomatic symptoms, the researchers suggest.
“The discussion of symptoms with pragmatically oriented trauma center providers may facilitate early mental health screening and intervention procedures targeting the complexity of PTSD and depression, and somatic amplification,” Zatzick says. “Similarly, mental health professionals working in the acute care medical setting may be able to identify patients who are amplifying somatic complaints.”
Interviews: Contact Douglas F. Zatzick, M.D. 01-206-341-4209, dzatzick@u.Washington.edu
Psychosomatics: Contact Tom Wise, M.D., at tel. 01-703-698-3626
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