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Merrill RM, Ashton MK. How Do Mental Disorders and Combinations of Disorders Affect the Odds of Injuries and Poisoning? J Nerv Ment Dis 2024; 212:303-311. [PMID: 38704650 DOI: 10.1097/nmd.0000000000001771] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 05/06/2024]
Abstract
ABSTRACT Injuries and poisoning are associated with mental disorders. The association may be stronger if comorbid mental illness is involved. This study explores whether selected mental disorders (stress, anxiety, depression, attention deficit hyperactivity disorder [ADHD], bipolar, obsessive-compulsive disorder [OCD], schizophrenia) are associated with injuries and poisoning and if the presence and frequency of comorbid mental illness affect these associations. Analyses utilize medical claims data for adult employees of a large corporation during 2017-2021. Approximately half or more of the index mental disorders experience comorbid mental illness. Odds of injury and poisoning are significantly greater for each mental disorder and tend to be significantly greater when comorbid mental illness exists ( vs . the mental disorder alone), especially for the associations involving poisoning. Schizophrenia alone and in combination with other mental illness has the strongest associations with injury and poisoning. OCD is only associated with injury and poisoning, and ADHD is only associated with poisoning, if accompanied by comorbid mental illness.
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Affiliation(s)
- Ray M Merrill
- Department of Public Health, College of Life Sciences, Brigham Young University, Provo, Utah
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Ng VWS, Gao L, Chan EW, Lee HME, Hayes JF, Osborn DPJ, Rainer TH, Man KKC, Wong ICK. Association between the pharmacological treatment of bipolar disorder and risk of traumatic injuries: a self-controlled case series study. Psychol Med 2023; 53:5185-5193. [PMID: 35866370 DOI: 10.1017/s0033291722002215] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Abstract
BACKGROUND Patients with bipolar disorder (BPD) are prone to engage in risk-taking behaviours and self-harm, contributing to higher risk of traumatic injuries requiring medical attention at the emergency room (ER).We hypothesize that pharmacological treatment of BPD could reduce the risk of traumatic injuries by alleviating symptoms but evidence remains unclear. This study aimed to examine the association between pharmacological treatment and the risk of ER admissions due to traumatic injuries. METHODS Individuals with BPD who received mood stabilizers and/or antipsychotics were identified using a population-based electronic healthcare records database in Hong Kong (2001-2019). A self-controlled case series design was applied to control for time-invariant confounders. RESULTS A total of 5040 out of 14 021 adults with BPD who received pharmacological treatment and had incident ER admissions due to traumatic injuries from 2001 to 2019 were included. An increased risk of traumatic injuries was found 30 days before treatment [incidence rate ratio (IRR) 4.44 (3.71-5.31), p < 0.0001]. After treatment initiation, the risk remained increased with a smaller magnitude, before returning to baseline [IRR 0.97 (0.88-1.06), p = 0.50] during maintenance treatment. The direct comparison of the risk during treatment to that before and after treatment showed a significant decrease. After treatment cessation, the risk was increased [IRR 1.34 (1.09-1.66), p = 0.006]. CONCLUSIONS This study supports the hypothesis that pharmacological treatment of BPD was associated with a lower risk of ER admissions due to traumatic injuries but an increased risk after treatment cessation. Close monitoring of symptoms relapse is recommended to clinicians and patients if treatment cessation is warranted.
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Affiliation(s)
- Vanessa W S Ng
- Centre for Safe Medication Practice and Research, Department of Pharmacology and Pharmacy, The University of Hong Kong, Hong Kong, China
| | - Le Gao
- Centre for Safe Medication Practice and Research, Department of Pharmacology and Pharmacy, The University of Hong Kong, Hong Kong, China
| | - Esther W Chan
- Centre for Safe Medication Practice and Research, Department of Pharmacology and Pharmacy, The University of Hong Kong, Hong Kong, China
- Laboratory of Data Discovery for Health (D24H), Hong Kong Science Park, Hong Kong, China
| | - Ho Ming Edwin Lee
- Department of Psychiatry, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Hong Kong, China
| | - Joseph F Hayes
- Division of Psychiatry, Faculty of Brain Sciences, University College London, London, UK
| | - David P J Osborn
- Division of Psychiatry, Faculty of Brain Sciences, University College London, London, UK
- Camden and Islington NHS Foundation Trust, London NW10PE, UK
| | - Timothy H Rainer
- Emergency Medicine Unit, The University of Hong Kong, Hong Kong, China
| | - Kenneth K C Man
- Centre for Safe Medication Practice and Research, Department of Pharmacology and Pharmacy, The University of Hong Kong, Hong Kong, China
- Laboratory of Data Discovery for Health (D24H), Hong Kong Science Park, Hong Kong, China
- Research Department of Practice and Policy, School of Pharmacy, University College London, London, UK
| | - Ian C K Wong
- Centre for Safe Medication Practice and Research, Department of Pharmacology and Pharmacy, The University of Hong Kong, Hong Kong, China
- Laboratory of Data Discovery for Health (D24H), Hong Kong Science Park, Hong Kong, China
- Research Department of Practice and Policy, School of Pharmacy, University College London, London, UK
- Aston Pharmacy School, Aston University, Birmingham B4 7ET, UK
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Quintana M, Bornstein S, Zwemer C, Zebley JA, Amdur R, Trankiem CT, Burd RS, McKenna E, Williams M, Sarani B. A multicenter, citywide report on recurrent violent injury. Injury 2023:S0020-1383(23)00245-0. [PMID: 36925376 DOI: 10.1016/j.injury.2023.03.005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/15/2022] [Revised: 02/28/2023] [Accepted: 03/06/2023] [Indexed: 03/18/2023]
Abstract
INTRODUCTION The incidence of and risk factors for recurrent violent trauma are not well known. This information is needed to focus violence prevention efforts on at-risk cohorts. The purpose of this study was to determine the incidence of and risk factors for recurrence following violent injury in a large urban setting. We hypothesize that the overall incidence of recurrent violent injury is low but there are specific at-risk cohorts. METHODS A retrospective, citywide study of patients who sustained blunt assault or penetrating trauma from 2013 to 2019 was performed. Patients were tracked across all trauma centers using their name and date of birth. The primary outcome was incidence of recurrent violent injury, which was calculated by dividing the number of readmitted patients by the number who survived previous admissions due to penetrating trauma or blunt assault. Associations between readmission and injury severity score, abbreviated injury score, age, sex, hospital, mechanism of injury (MOI), and disposition were determined. Kaplan-Meier curves were plotted to determine the incidence of recurrent injury over time. A multivariable Cox proportional hazard model was used to examine the relationships between characteristics at first admission and time-to-readmission. RESULTS The recurrent injury rate was 836 patients (6.33%) out of 13,211 injured patients. Male, age 14-45 years old, discharge to jail or left against medical advice, and moderate/severe head injury were associated with re-injury. There was no association between recurrence and mechanism of injury or overall injury severity. Discharge to home was associated with a lower re-injury rate. CONCLUSION The low recurrent injury rate despite high injury prevalence suggests injury prevention efforts should target this demographic and their non-injured peers.
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Affiliation(s)
- Megan Quintana
- Department of Surgery, Center for Trauma and Critical Care, George Washington University, 2150 Pennsylvania Ave, NW, Suite 6B, Washington, DC 20037, USA
| | - Sydney Bornstein
- Department of Surgery, Center for Trauma and Critical Care, George Washington University, 2150 Pennsylvania Ave, NW, Suite 6B, Washington, DC 20037, USA
| | - Catherine Zwemer
- Department of Surgery, Center for Trauma and Critical Care, George Washington University, 2150 Pennsylvania Ave, NW, Suite 6B, Washington, DC 20037, USA
| | - James A Zebley
- Department of Surgery, Center for Trauma and Critical Care, George Washington University, 2150 Pennsylvania Ave, NW, Suite 6B, Washington, DC 20037, USA
| | - Richard Amdur
- Department of Surgery, Center for Trauma and Critical Care, George Washington University, 2150 Pennsylvania Ave, NW, Suite 6B, Washington, DC 20037, USA
| | - Christine T Trankiem
- Division of Trauma, Department of Surgery, MedStar Washington Hospital Center, Washington, DC, USA
| | - Randall S Burd
- Department of Pediatric Surgery, Children's National Medical Center, Washington, DC, USA
| | - Elise McKenna
- Department of Pediatric Surgery, Children's National Medical Center, Washington, DC, USA
| | - Mallory Williams
- Department of Surgery, Howard University Hospital, Washington, DC, USA
| | - Babak Sarani
- Department of Surgery, Center for Trauma and Critical Care, George Washington University, 2150 Pennsylvania Ave, NW, Suite 6B, Washington, DC 20037, USA.
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Major Prehospital Trauma and In-Hospital Emergencies: Massive Transfusion Triggers. Dimens Crit Care Nurs 2021; 40:192-201. [PMID: 33792279 DOI: 10.1097/dcc.0000000000000477] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
Abstract
BACKGROUND Massive transfusion (MT) in trauma is initiated on the basis of factors of different natures and depending on protocols and scales used both in prehospital and in-hospital care areas. OBJECTIVE The main goal was to analyze and relate factors and predictive variables for MT requirements considering both health care areas. METHOD This was a retrospective cohort study that included patients who were treated either at the emergency department of a large hospital or through prehospital care before arrival at the hospital. The patients included were adults who received MT, defined as a blood bank request of 10 or more units of red cells in the first 24 hours or 5 or more within 4 hours of trauma, from January 1, 2009, to January 1, 2017. The variables included were individual characteristics and those associated with the trauma, clinical-analytical assessment, resuscitation, timing, and survival. RESULTS A total of 52 patients who received MT were included. The average age of the patients was 41.23 ± 16.06 years, a mean of 19.56 ± 12.77 units was administered, and the mortality rate was 21.2%. DISCUSSION Injury mechanism, clinical-analytical variables, and resuscitation strategies have a significant influence on the need for MT; therefore, early identification is fundamental for performing quality management and addressing avoidable factors during MT processes.
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McQuillan TJ, Franco JR, Sorg EM, Baller E, Quijije N, Rozental TD. Understanding and Addressing Psychiatric Comorbidities and Upper-Extremity Trauma: Surgeons in a Multidisciplinary Care Model. J Hand Surg Am 2021; 46:328-334. [PMID: 33637395 DOI: 10.1016/j.jhsa.2021.01.005] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/19/2020] [Revised: 11/23/2020] [Accepted: 01/14/2021] [Indexed: 02/02/2023]
Abstract
Psychiatric disorders are a common cause of disability and represent an important risk factor for upper-extremity trauma. The review provides an overview of psychiatric illnesses as both contributors and sequelae of 4 major injury patterns: self-inflicted wrist lacerations, self-amputation, upper-extremity fractures, and burns. The authors develop a multidisciplinary model for upper-extremity surgeons to care for patients with psychiatric disorders, with an overview of capacity assessment, optimal psychiatric comanagement, and collaboration with allied health professionals.
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Affiliation(s)
| | | | - Emily M Sorg
- Department of Psychiatry, Harvard Medical School, Massachusetts General Hospital, Boston, MA
| | - Erica Baller
- Department of Psychiatry, Harvard Medical School, Massachusetts General Hospital, Boston, MA
| | - Nadia Quijije
- Department of Psychiatry, Harvard Medical School, Massachusetts General Hospital, Boston, MA
| | - Tamara D Rozental
- Department of Orthopaedic Surgery, Harvard Medical School, Beth Israel Deaconess, Boston, MA.
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Chang C, Yeh M, Chien W, Chung C, Li T, Lai EC. Interactions between psychiatric and physical disorders and their effects on the risks of suicide: a nested case–control study. Ann N Y Acad Sci 2019; 1462:79-91. [DOI: 10.1111/nyas.14216] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/29/2019] [Revised: 06/24/2019] [Accepted: 07/22/2019] [Indexed: 11/27/2022]
Affiliation(s)
- Ching‐Feng Chang
- Graduate Institute of Medical SciencesNational Defense Medical Center Taipei Taiwan
- Department of RadiologyTri‐Service General Hospital Taipei Taiwan
| | - Ming‐kung Yeh
- Graduate Institute of Medical SciencesNational Defense Medical Center Taipei Taiwan
- School of Pharmacy, Graduate Institute of Medical SciencesNational Defense Medical Center Taipei Taiwan
| | - Wu‐Chien Chien
- School of Public HealthNational Defense Medical Center Taipei Taiwan
| | - Chi‐Hsiang Chung
- School of Public HealthNational Defense Medical Center Taipei Taiwan
| | - Tzu‐Ting Li
- Department of RadiologyTri‐Service General Hospital Taipei Taiwan
| | - Edward Chia‐Cheng Lai
- School of Pharmacy, College of Medicine, Institute of Clinical Pharmacy and Pharmaceutical SciencesNational Cheng Kung University Tainan Taiwan
- Department of PharmacyNational Cheng Kung University Hospital Tainan Taiwan
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Onyeka IN, Collier Høegh M, Nåheim Eien EM, Nwaru BI, Melle I. Comorbidity of Physical Disorders Among Patients With Severe Mental Illness With and Without Substance Use Disorders: A Systematic Review and Meta-Analysis. J Dual Diagn 2019; 15:192-206. [PMID: 31164045 DOI: 10.1080/15504263.2019.1619007] [Citation(s) in RCA: 28] [Impact Index Per Article: 5.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
Abstract
Objective: Physical disorders in patients with severe mental illness (SMI) are common and they tend to be underdiagnosed by clinicians, which might lead to negative treatment outcomes. The presence of substance use disorders could further aggravate the situation. There are existing systematic reviews on physical disorders among individuals with SMI in general but none of these previous reviews stratified their findings by substance use disorder status. This study aimed to synthesize the evidence on the frequency of comorbid physical disorders among patients with SMI with or without substance use disorders. Methods: We searched for studies published in English between 1988 and 2017 in MEDLINE, Embase, CINAHL, PsycINFO, Global Health, Web of Science, Scopus, WHO Global Health Library (Global Index Medicus), Google Scholar, OpenGrey, the Grey Literature Report, Cochrane Library, International Standardized Randomized Controlled Trial Number Registry, WHO International Clinical Trials Registry Platform, ClinicalTrials.gov, Australian and New Zealand Clinical Trials Registry, and PROSPERO. There was no geographical restriction and the target population was adults (≥18 years) with diagnosed SMI including schizophrenia, bipolar disorder, and other psychotic illnesses. The outcome of interest was physical disorder. Results: A total of 6,994 records were retrieved. Only 30 papers (representing 24 studies) met our inclusion criteria and 13 studies were included in the meta-analysis. The prevalence of most of the reported physical disorders was higher in SMI patients with substance use disorders than in those without substance use disorders. When ranked according to pooled prevalence level, hypertension (35.6%), tardive dyskinesia (35.4%), and hepatitis C (26.9%) were the most prevalent physical disorders among SMI patients with substance use disorders. For SMI patients without substance use disorders, hypertension (32.5%), tardive dyskinesia (25.1%), and endocrine disease (19.0%) were more common. Estimates for diabetes (7.5% vs. 7.5%) and cardiovascular diseases (11.8% vs. 11.3%) were similar across groups. Conclusions: Physical disorders among SMI patients vary by substance use disorder status. Clinicians managing SMI in patients should screen for physical disorders and substance use disorders and provide treatment or referral. Registration: International Prospective Register of Systematic Reviews (PROSPERO) registration number CRD42017072286.
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Affiliation(s)
- Ifeoma N Onyeka
- NORMENT K.G. Jebsen Centre for Psychosis Research, Institute of Clinical Medicine, University of Oslo and Oslo University Hospital , Oslo , Norway.,UKCRC Centre of Excellence for Public Health (Northern Ireland), Centre for Public Health, Queen's University Belfast, Royal Victoria Hospital , Belfast , UK
| | - Margrethe Collier Høegh
- NORMENT K.G. Jebsen Centre for Psychosis Research, Institute of Clinical Medicine, University of Oslo and Oslo University Hospital , Oslo , Norway
| | | | - Bright I Nwaru
- Krefting Research Centre, Institute of Medicine, University of Gothenburg , Gothenburg , Sweden.,Wallenberg Centre for Molecular and Translational Medicine, Institute of Medicine, University of Gothenburg , Gothenburg , Sweden
| | - Ingrid Melle
- NORMENT K.G. Jebsen Centre for Psychosis Research, Institute of Clinical Medicine, University of Oslo and Oslo University Hospital , Oslo , Norway
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Young JT, Borschmann R, Preen DB, Spittal MJ, Brophy L, Wang EA, Heffernan E, Kinner SA. Age-specific incidence of injury-related hospital contact after release from prison: a prospective data-linkage study. Inj Prev 2019; 26:204-214. [DOI: 10.1136/injuryprev-2018-043092] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/29/2018] [Revised: 02/25/2019] [Accepted: 03/01/2019] [Indexed: 11/03/2022]
Abstract
BackgroundIn population studies, the risk of injury declines after early adulthood. It is unclear if a similar age difference in the risk of injury exists among people released from prison.MethodsPrerelease survey data collected between 1 August 2008 and 31 July 2010, from a representative cohort of sentenced adults (≥18 years) in Queensland, Australia, were linked prospectively and retrospectively to person-level emergency department, inpatient hospital and correctional records. To ascertain predictors of injury-related hospital contact, we fit a multivariate Andersen-Gill model and tested the interactions between age group (<25 years, ≥25 years) and each variable.ResultsIn 1307 adults released from prison, there were 3804 person-years of follow-up. The crude injury rate was 385 (95% CI 364 to 407) per 1000 person-years and did not differ according to age group. Factors associated with increased injury-related hospital contact included a history of mental illness, preincarceration injury, a history of incarceration, release from a short prison sentence (<90 days), being reincarcerated during follow-up and identifying as Indigenous. The effect of mental illness, risky alcohol use, prior incarceration and intellectual disability differed across age group and predicted increased risk of injury among people aged ≥25 years compared with their counterparts without these characteristics.ConclusionsUnlike in the general population where the risk of injury declines with age, older adults released from prison are at similar risk compared with their younger peers. Adults released from prison with mental illness, a history of injury-related hospital contact and who identify as Indigenous are particularly indicated groups for injury prevention.
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Outcomes after traumatic injury in patients with preexisting psychiatric illness. J Trauma Acute Care Surg 2017; 83:882-887. [PMID: 28538629 DOI: 10.1097/ta.0000000000001588] [Citation(s) in RCA: 25] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Abstract
BACKGROUND Patients with psychiatric illness have been shown to experience higher rates of traumatic injury. Injury patterns, treatment decisions, and outcomes have not been well characterized in patients with psychiatric illness after injury, in particular those who undergo acute surgical intervention. The purpose of this analysis was to determine mortality, complications, and surgical intervention rates in patients with psychiatric illness after traumatic injury. METHODS This is a retrospective study of trauma patients ≥18 years old admitted to LAC + USC Medical Center between January 2008 and March 2015. Patients with psychiatric diagnoses were identified using ICD-9 diagnosis codes. Multivariate logistic regression analyses taking into account demographic and injury characteristics were used to identify associations between psychiatric comorbidity, injury mechanism, surgical interventions, and outcomes in patients after injury. RESULTS A total of 26,502 patients were analyzed. Of these, 3,040 (11.5%) had a documented psychiatric comorbidity (2.0% depressive disorder, 0.8% bipolar disorder, 1.3% schizophrenia, 0.5% anxiety disorder, 3.2% substance use disorder). Patients with psychiatric illness were significantly older (49.6 years vs. 42.0 years, p < 0.001), had a lower proportion of penetrating injuries (13.8% vs. 18.1%, p < 0.001), and had a higher incidence of self-inflicted injuries (11.6% vs. 0.72%, p < 0.001). No difference in gender distribution was observed (74.2% men vs. 74.4% men, p = 0.80). Overall mortality was similar in both groups (adjusted odds ratio [aOR], 0.73; p = 0.07). Patients with psychiatric illness were significantly less likely to undergo acute surgical intervention within 6 hours of emergency department admission (aOR, 0.64; p < 0.001). Time from ED arrival to consent for acute surgical intervention was similar in both groups (94.8 min vs. 93.0 min, p = 0.84). No significant difference in mortality after acute surgical intervention was observed (aOR, 0.26; p = 0.10). Psychiatric illness was associated with a significantly higher likelihood of developing complications (aOR, 1.90; p < 0.001) and longer hospital lengths of stay (10.6 days vs. 6.2 days, p < 0.001). CONCLUSIONS Trauma patients with comorbid psychiatric illness were observed to have lower rates of acute surgical interventions, higher complication rates, and longer hospital lengths of stay. Further studies are needed to better characterize the causative factors underlying these associations. LEVEL OF EVIDENCE Epidemiological, level III.
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SHADLOO B, MOTEVALIAN A, RAHIMI-MOVAGHAR V, AMIN-ESMAEILI M, SHARIFI V, HAJEBI A, RADGOODARZI R, HEFAZI M, RAHIMI-MOVAGHAR A. Psychiatric Disorders Are Associated with an Increased Risk of Injuries: Data from the Iranian Mental Health Survey (IranMHS). IRANIAN JOURNAL OF PUBLIC HEALTH 2016; 45:623-35. [PMID: 27398335 PMCID: PMC4935706] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Subscribe] [Scholar Register] [Indexed: 10/29/2022]
Abstract
BACKGROUND Injuries and psychiatric disorders, notably both major public health concerns, are associated with a high burden and are believed to be bi-directionally correlated. Those inflicted with injuries face increased risks of mental illnesses. Psychiatric disorders may make the individual prone to injuries. The objective of the study was to assess the correlation of mental disorders with non-fatal injuries. METHODS A total of 7886 participants aged 15 to 64 yr were interviewed in a national household survey in 2011 in Iran. Composite International Diagnostic Interview (CIDI v2.1) was implemented to assess the prevalence of psychiatric disorders in the past twelve months. Injuries were assessed using Short Form Injury Questionnaire (SFIQ-7). RESULTS Injury was reported in 35.9% and 22.8% of participants in the past twelve and past three months, respectively. Using multivariate logistic regression analysis, mental disorders were significantly associated with injuries in the past three months (OR=1.6, 95% CI:1.36-1.87), recurrent injuries (OR=1.7, 95% CI: 1.21-2.41) and road/traffic accidents (OR=2.4, 95% CI: 1.28-4.49). CONCLUSION Psychiatric disorders were found to be associated with an increased risk of injuries. Early detection and treatment of mental illnesses can contribute to injury prevention.
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Affiliation(s)
- Behrang SHADLOO
- Sina Trauma and Surgery Research Center, Tehran University of Medical Sciences, Tehran, Iran,Iranian National Center for Addiction Studies (INCAS), Iranian Institute for Reduction of High-Risk Behavior, Tehran University of Medical Sciences, Tehran, Iran
| | - Abbas MOTEVALIAN
- Dept. of Epidemiology, School of Public Health, Iran University of Medical Sciences, Tehran, Iran
| | - Vafa RAHIMI-MOVAGHAR
- Sina Trauma and Surgery Research Center, Tehran University of Medical Sciences, Tehran, Iran
| | - Masoumeh AMIN-ESMAEILI
- Iranian National Center for Addiction Studies (INCAS), Iranian Institute for Reduction of High-Risk Behavior, Tehran University of Medical Sciences, Tehran, Iran,Corresponding Author:
| | - Vandad SHARIFI
- Psychiatry and Psychology Research Center, Tehran University of Medical Sciences, Tehran, Iran
| | - Ahmad HAJEBI
- Mental Health Research Center, Tehran Psychiatric Institute, Iran University of Medical Sciences, Tehran, Iran
| | - Reza RADGOODARZI
- Iranian National Center for Addiction Studies (INCAS), Iranian Institute for Reduction of High-Risk Behavior, Tehran University of Medical Sciences, Tehran, Iran
| | - Mitra HEFAZI
- Iranian National Center for Addiction Studies (INCAS), Iranian Institute for Reduction of High-Risk Behavior, Tehran University of Medical Sciences, Tehran, Iran
| | - Afarin RAHIMI-MOVAGHAR
- Iranian National Center for Addiction Studies (INCAS), Iranian Institute for Reduction of High-Risk Behavior, Tehran University of Medical Sciences, Tehran, Iran
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Prevalence and predictors of mental disorders in intentionally and unintentionally injured emergency center patients. J Nerv Ment Dis 2014; 202:638-46. [PMID: 25126754 PMCID: PMC4170144 DOI: 10.1097/nmd.0000000000000176] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/22/2022]
Abstract
Little is known about the prevalence and predictors of mental disorders among injured emergency center (EC) patients in low- and middle-income countries (LMICs). Patients presenting with either an intentional or unintentional injury were recruited (N = 200). Mental health, injury, and psychological trauma histories were assessed. Descriptive statistics and logistic regressions were conducted, and predictors of current mental disorder were identified. Diagnostic criteria for a current mental disorder, including substance use disorders, were met by 59.5% of the participants. Compared with those with an unintentional injury, the intentionally injured participants were more likely to be diagnosed with a current mental disorder (66.9% vs. 48.8%, p = .01). High frequencies of previous intentional injuries predicted for current mental disorder (OR = 1.46, 95% CI 1.08-1.98), whereas male gender and witnessed community violence predicted substance use disorder diagnoses. The findings indicate that injured EC patients, particularly those with intentional injuries, are at risk for mental disorders. Psychosocial interventions in the EC context can potentially make an important contribution in reducing the burden of mental disorders and injuries in LMICs.
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McAninch J, Greene C, Sorkin JD, Lavoie MC, Smith GS. Higher psychological distress is associated with unintentional injuries in US adults. Inj Prev 2013; 20:258-65. [PMID: 24174466 DOI: 10.1136/injuryprev-2013-040958] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
Abstract
BACKGROUND Links between mental illness, self-inflicted injury and interpersonal violence are well recognised, but the association between poor mental health and unintentional injuries is not well understood. METHODS We used the 2010 National Health Interview Survey to assess the association between psychological distress and unintentional non-occupational injuries among US adults. Psychological distress was measured by the Kessler Psychological Distress Scale, a symptom scale shown to identify community-dwelling persons with mental illness. Multivariable logistic regression was used to estimate adjusted ORs (AOR) and 95% CIs. RESULTS Of the 26,776 individuals analysed, 2.5% reported a medically attended unintentional injury in the past 3 months. Those with moderate and severe psychological distress had 1.5 (1.2 to 1.8) and 2.0 (1.4 to 2.8) times higher odds of injury, respectively, as compared to those with low distress levels, after adjusting for age, sex, race, marital status, education level, alcohol use, physical functional limitation, medical comorbidity, employment status and health insurance status. Psychological distress was significantly associated with falls (AOR 1.4 (1.1 to 1.9)) and sprain/strain injuries (AOR 2.0 (1.5 to 2.8)), but not transportation-related injuries (AOR 1.2 (0.7 to 1.9)) or fractures (AOR 1.1 (0.8 to 1.6)). CONCLUSIONS Among community-dwelling US adults, psychological distress is significantly associated with unintentional non-occupational injury, and the magnitude of association increases with severity of distress. The association between psychological distress and injury may be particularly strong for falls and sprain/strain injuries. These findings draw attention to a large group of at-risk individuals that may merit further targeted research, including longitudinal studies.
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Affiliation(s)
- Jana McAninch
- Department of Epidemiology and Public Health, University of Maryland Baltimore School of Medicine, Baltimore, Maryland, USA
| | - Christina Greene
- Department of Epidemiology and Public Health, University of Maryland Baltimore School of Medicine, Baltimore, Maryland, USA
| | - John D Sorkin
- Baltimore VA Medical Center, Geriatrics Research, Education, and Clinical Center, Baltimore, Maryland, USA University of Maryland School of Medicine Claude D. Pepper Older Americans Independence Center, Baltimore, Maryland, USA
| | - Marie-Claude Lavoie
- Department of Epidemiology and Public Health, University of Maryland Baltimore School of Medicine, Baltimore, Maryland, USA
| | - Gordon S Smith
- Department of Epidemiology and Public Health, University of Maryland Baltimore School of Medicine, Baltimore, Maryland, USA Shock, Trauma and Anesthesiology Research (STAR)-Organized Research Center, University of Maryland Baltimore, Baltimore, Maryland, USA
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