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            "title": "Posttraumatic stress disorder and depression negatively impact general health status after hand injury",
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                    "creatorType": "author",
                    "firstName": "Allison E",
                    "lastName": "Williams"
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                {
                    "creatorType": "author",
                    "firstName": "Justin T",
                    "lastName": "Newman"
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                    "firstName": "Kagan",
                    "lastName": "Ozer"
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                    "lastName": "Juarros"
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                    "creatorType": "author",
                    "firstName": "Wade R",
                    "lastName": "Smith"
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            "abstractNote": "PURPOSE: To estimate the prevalence of posttraumatic stress disorder (PTSD) and depression among hand-injured patients and assess the impact of these disorders on general health status.\nMETHODS: A total of 106 adult hand-injured patients (40 women, 66 men) with a mean age of 42 years (range, 18-79 years) participated. Patients with a chronic mental illness or cognitive impairment were excluded. Psychological status was assessed using the Revised Civilian Mississippi Scale for PTSD and the Beck Depression Inventory. General health status was evaluated with the Short Form-36 health survey (SF-36). We obtained demographics and injury characteristics from the patient medical records.\nRESULTS: Prominent mechanisms of injury included a fall (n = 38), traffic-related injuries (n = 14), machine versus operator (n = 8), gunshot wounds (n = 6), and assault (n = 6). Using the screening questionnaires, 32 persons qualified for PTSD and 19 for depression. Sixteen patients met the criteria for both PTSD and depression. The association between PTSD and depression was significant (p < .01). Patients with PTSD had significantly lower scores than those who did not endorse items consistent with PTSD or depression on the SF-36 subscales of role-emotional (p < .01), body pain (p = .013), social function (p = .028), and mental health (p < .01). We found no significant differences between groups for the subscales of role-physical (p = .289), general health (p = .147), vitality (p = .496), and physical functioning (p = .476). Patients who had concurrent PTSD and depression had significantly lower scores than patients who had neither PTSD nor depression on all subscales (p < .05 for all) except role-physical (p = .135). We found significant negative correlations between Beck Depression Inventory scores and all of the SF-36 subscales (p < .05 for all).\nCONCLUSIONS: In this study, nearly one third of hand-injured patients met diagnostic criteria for PTSD, depression, or both, according to the thresholds of the instruments used to measure these psychological aspects of illness. PTSD and depression had a negative effect on general health status after hand injury. It may be important to consider psychological status when caring for patients with hand injuries.",
            "publicationTitle": "The Journal of hand surgery",
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            "date": "Mar 2009",
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            "pages": "515-522",
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            "abstractNote": "NARRATIVE REVIEW: Pain is considered a fundamental ramification of hand injury and has been identified as one of the most acutely stressful aspects of traumatic injuries and their treatment. Both comorbid psychiatric conditions and psychosocial factors have been shown to affect medical treatment outcome in patients with hand disorders and pain, further complicating recovery and potentially leading to significant psychological, social, and economic consequences for the individual. The purpose of this article was to assist hand therapists in developing a greater understanding of psychological constructs, psychosocial variables, and comorbid psychiatric conditions and thereby facilitate the more effective identification of such factors. A case study is included to illustrate these concepts. Circumstances in which referral for a comprehensive psychological evaluation is necessary are discussed. Many of the principles reviewed are also applicable to other upper extremity and musculoskeletal conditions.",
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                    "creatorType": "author",
                    "firstName": "Lonneke",
                    "lastName": "Opsteegh"
                },
                {
                    "creatorType": "author",
                    "firstName": "Heleen A",
                    "lastName": "Reinders-Messelink"
                },
                {
                    "creatorType": "author",
                    "firstName": "Johan W",
                    "lastName": "Groothoff"
                },
                {
                    "creatorType": "author",
                    "firstName": "Klass",
                    "lastName": "Postema"
                },
                {
                    "creatorType": "author",
                    "firstName": "Pieter U",
                    "lastName": "Dijkstra"
                },
                {
                    "creatorType": "author",
                    "firstName": "Corry K",
                    "lastName": "van der Sluis"
                }
            ],
            "abstractNote": "PURPOSE: Symptoms of posttraumatic stress disorder (PTSD) in patients with hand injuries may delay return to work, even when criteria of the Diagnostic and Statistical Manual of Mental Disorders-IV are not met. This study investigated which biomedical and psychosocial factors relate to symptoms of acute PTSD in hand-injured patients.\nMETHODS: Sixty-seven employed patients with hand injuries completed a number of questionnaires. The following factors were investigated: sociodemographic characteristics, injury severity, accident location, pain, satisfaction with hand functioning, aesthetics of the hand, social support, and coping styles. The primary outcome measure was the number of symptoms of PTSD. We analyzed factors that were univariately significantly associated with symptoms of PTSD using linear regression analysis, and explored interaction effects.\nRESULTS: One patient met the criteria for PTSD; 44 patients experienced symptoms but did not meet the criteria (median, 1; interquartile range (IQR), 0-2); 22 patients experienced no symptoms of PTSD. Patients had a median pain score of 30 (IQR, 10-45), median satisfaction score of 60 (IQR, 45-70), median aesthetics score of 66.7 (IQR, 45.8-79.2), median palliative coping style score of 16 (IQR, 14.8-17.3), and median avoidance coping style of 15 (IQR, 13-16). Symptoms of PTSD were associated with pain (r, .530; p < .001), satisfaction with hand function (r, -.451; p < .001), aesthetics (r, -.320; p = .009), palliative coping style (r, .281; p = .022) and avoidance coping style (r, .283; p = .022). Pain and aesthetics remained significant after regression analysis. No interaction effects were significant.\nCONCLUSIONS: Pain and aesthetics statistically predict symptoms of acute PTSD in patients with acute hand injuries. Patients with disproportionate pain or dissatisfaction with aesthetics should be evaluated for PTSD.\nTYPE OF STUDY/LEVEL OF EVIDENCE: Prognostic IV.",
            "publicationTitle": "The Journal of hand surgery",
            "publisher": "",
            "place": "",
            "date": "Jun 2010",
            "volume": "35",
            "issue": "6",
            "section": "",
            "partNumber": "",
            "partTitle": "",
            "pages": "961-967",
            "series": "",
            "seriesTitle": "",
            "seriesText": "",
            "journalAbbreviation": "J Hand Surg Am",
            "DOI": "10.1016/j.jhsa.2010.03.024",
            "citationKey": "",
            "url": "",
            "accessDate": "",
            "PMID": "",
            "PMCID": "",
            "ISSN": "1531-6564",
            "archive": "",
            "archiveLocation": "",
            "shortTitle": "",
            "language": "eng",
            "libraryCatalog": "NCBI PubMed",
            "callNumber": "",
            "rights": "",
            "extra": "PMID: 20513577",
            "tags": [
                {
                    "tag": "Adaptation, Psychological",
                    "type": 1
                },
                {
                    "tag": "Adult",
                    "type": 1
                },
                {
                    "tag": "Cross-Sectional Studies",
                    "type": 1
                },
                {
                    "tag": "Female",
                    "type": 1
                },
                {
                    "tag": "Hand Injuries",
                    "type": 1
                },
                {
                    "tag": "Humans",
                    "type": 1
                },
                {
                    "tag": "Linear Models",
                    "type": 1
                },
                {
                    "tag": "Male",
                    "type": 1
                },
                {
                    "tag": "Middle Aged",
                    "type": 1
                },
                {
                    "tag": "Pain Measurement",
                    "type": 1
                },
                {
                    "tag": "Pain, Postoperative",
                    "type": 1
                },
                {
                    "tag": "Patient Satisfaction",
                    "type": 1
                },
                {
                    "tag": "Social Support",
                    "type": 1
                },
                {
                    "tag": "Stress Disorders, Post-Traumatic",
                    "type": 1
                }
            ],
            "collections": [],
            "relations": {},
            "dateAdded": "2013-10-31T13:47:21Z",
            "dateModified": "2013-10-31T13:47:21Z"
        }
    }
]