Associations of serious physical injuries with posttraumatic stress and depressive symptoms: a cross-sectional survey among university students in 26 countries

Abstract

Background Evidence of the relationship between serious physical injury and poor mental health among university students from low- and middle-income countries is limited. The aim of the study is to assess the association between serious physical injury and posttraumatic stress disorder (PTSD) and depressive symptoms in university students from low- and middle-income countries. Methods In a cross-sectional survey, 18,382 university students from 26 countries responded to a short screening scale for DSM-IV PTSD, Center for Epidemiologic Studies Depression Scale as well as questions on injury and sociodemographics. Results The overall prevalence of past 12-month serious physical injury was 24.7%. In adjusted logistic regression analysis, compared to having no past 12-month serious physical injury, having a past 12-month serious injury was associated with 1.35 (95% CI 1.18, 1.56) times higher odds for PTSD symptoms and 1.49 (95% CI 1.32, 1.67) times higher odds for depressive symptoms in university students. Conclusion Compared to students who had not sustained a serious physical injury in the past 12 months, students with an injury had significantly higher PTSD and depressive symptoms. Mental health support of students who sustained physical injuries may prevent PTSD and depressive symptoms.

Rates of injury according to a single or comorbid mental illness identified in a large employee database

“…It is well known that mental illnesses are associated with injuries and that the causal direction is bidirectional. 3 , 4 , 5 , 6 , 7 , 8 , 9 , 10 , 11 , 12 , 13 , 14 , 15 , 16 , 17 , 18 , 19 , 20 , 21 It is also well known that specific mental illnesses are often accompanied by comorbid mental illness and that more severe mental illnesses have a greater likelihood of comorbid mental illness. 22 , 23 , 24 , 25 , 26 What is less well known is whether mental illness is associated with specific types of injury and the number of types of injuries.…”

“…It is well known that mental illnesses are associated with injuries and that the causal direction is bidirectional 3–21 . It is also well known that specific mental illnesses are often accompanied by comorbid mental illness and that more severe mental illnesses have a greater likelihood of comorbid mental illness 22–26 .…”

“… 19 Additionally, the development of anxiety and PTSD have also been associated with injuries, while both anxiety and PTSD are associated risk factors for injuries. 4 , 20 , 21 …”

“…19 Additionally, the development of anxiety and PTSD have also been associated with injuries, while both anxiety and PTSD are associated risk factors for injuries. 4,20,21 A further issue that complicates the study of mental illness and injury is that injury may be impacted by whether the index mental illness is accompanied by comorbid mental illness. It is not uncommon for individuals to be diagnosed with two or more mental illnesses at the same time.…”

“…One study concluded that depression and injuries are risk factors for each other, with depression having a slightly higher influence on injury risk compared to injury and depression risk 19 . Additionally, the development of anxiety and PTSD have also been associated with injuries, while both anxiety and PTSD are associated risk factors for injuries 4,20,21 …”