Nearly half of
black men who come to a Philadelphia hospital with a physical
injury — anything from a sports accident to a gunshot wound
— develop depression or post traumatic stress disorder in
the following months, a new study found.
conducted by the University of Pennsylvania School of Nursing,
was published in JAMA Surgery. Here are the highlights:
A growing body
of research supports the idea that patients’ mental health
affects their physical outcomes. Some studies have shown that
patients with depression have longer hospital stays even when
they’re admitted for physical illnesses. Others have shown
that mental illness can slow recovery after surgery or other
People who have
experienced a traumatic event, such as a car crash or a
violent altercation, are particularly at risk of experiencing
symptoms of depression, anxiety, and PTSD.
Yet a national
survey found only 7% of trauma centers in U.S. hospitals
routinely screen patients for PTSD.
The research is
based on 500 adult black men who were treated for injury at
either the Hospital of the University of Pennsylvania or Penn
Presbyterian Medical Center. The study did not include men who
had a current psychotic disorder, were hospitalized because of
attempted suicide, or were currently receiving treatment for
depression or PTSD.
recruited the men between January 2013 and October 2017, and
followed each of them for three months after they left the
participants self-reported their symptoms of depression and
PTSD through surveys.
Of the 500 men
in the study, 225 met criteria for a mental health diagnosis
at the three-month follow up period. Of those, 13% screened
positive for depression, 10% for PTSD, and 22% for both.
violent injuries were more likely to show symptoms of mental
illness than those with non-violent injuries.
Men who had
experienced prior trauma or adverse childhood experiences —
like having an incarcerated family member or suffering
emotional or physical abuse — were at greatest risk. This is
supported by dozens of large-scale studies that show the more
adverse experiences people have as children, the more likely
they are to have poorer health outcomes as adults, including
said these results show that discharging men without screening
for psychological symptoms puts them at risk for poor
recovery, which can sometimes lead to long-term disability or
self-medication with prescription or non-prescription drugs.
study reinforced previous findings, it’s still important to
note it focused on participants from one Philadelphia hospital
system. The results might not apply to other populations.
The study also
relied on self-reported data for symptoms of depression and
PTSD, as well as adverse childhood effects, so these may not
have been entirely accurate.
suggest that addressing the psychological effects of injury
can improve health and reduce the negative outcomes of injury.
Screening patients for mental illness and asking about
traumatic childhood experiences could help identify those at
and Penn professor of nursing Therese Richmond said in a
statement, “We must integrate psychological care into the
very essence of trauma care if we are to improve outcomes from