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The effect of post-injury depression on return to pre-injury function: a prospective cohort study

Published online by Cambridge University Press:  02 March 2009

T. S. Richmond*
Affiliation:
School of Nursing, Biobehavioral and Health Sciences Division, University of Pennsylvania, Philadelphia, PA, USA
J. D. Amsterdam
Affiliation:
School of Medicine, Depression Research Unit, Department of Psychiatry, University of Pennsylvania, Philadelphia, PA, USA
W. Guo
Affiliation:
School of Medicine, Department of Clinical Epidemiology and Biostatistics, University of Pennsylvania, Philadelphia, PA, USA
T. Ackerson
Affiliation:
School of Nursing, University of Pennsylvania, Philadelphia, PA, USA
V. Gracias
Affiliation:
School of Medicine, Department of Surgery, University of Pennsylvania, Philadelphia, PA, USA
K. M. Robinson
Affiliation:
School of Medicine, Department of Physical Medicine and Rehabilitation, University of Pennsylvania, Philadelphia, PA, USA
J. E. Hollander
Affiliation:
School of Medicine, Department of Emergency Medicine, University of Pennsylvania, Philadelphia, PA, USA
*
*Address for correspondence: T. S. Richmond, Ph.D., CRNP, Associate Professor, University of Pennsylvania, School of Nursing, Fagin Hall, 418 Curie Blvd, Philadelphia, PA 19104, USA. (Email: terryr@nursing.upenn.edu)

Abstract

Background

Millions of people seek emergency department (ED) care for injuries each year, the majority for minor injuries. Little is known about the effect of psychiatric co-morbid disorders that emerge after minor injury on functional recovery. This study examined the effect of post-injury depression on return to pre-injury levels of function.

Method

This was a longitudinal cohort study with follow-up at 3, 6 and 12 months post-injury: 275 adults were randomly selected from those presenting to the ED with minor injury; 248 were retained over the post-injury year. Function was measured with the Functional Status Questionnaire (FSQ). Psychiatric disorders were diagnosed using the Structured Clinical Interview for DSM-IV-TR disorders (SCID).

Results

During the post-injury year, 18.1% [95% confidence interval (CI) 13.3–22.9] were diagnosed with depression. Adjusting for clinical and demographic covariates, the depressed group was less likely to return to pre-injury levels of activities of daily living [odds ratio (OR) 8.37, 95% CI 3.78–18.53] and instrumental activities of daily living (OR 3.25, 95% CI 1.44–7.31), less likely to return to pre-injury work status (OR 2.37, 95% CI 1.04–5.38), and more likely to spend days in bed because of health (OR 2.41, 95% CI 1.15–5.07).

Conclusions

Depression was the most frequent psychiatric diagnosis in the year after minor injury requiring emergency care. Individuals with depression did not return to pre-injury levels of function during the post-injury year.

Type
Original Articles
Copyright
Copyright © 2009 Cambridge University Press

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