Prevalence and predictive factors of psychological morbidity following facial injury: a prospective study of patients attending a maxillofacial outpatient clinic within a major UK city

Abstract

Adults presenting to maxillofacial surgery services are at high risk of psychological morbidity. This study examined the prevalence of depression, post-traumatic stress disorder (PTSD), anxiety, drug and alcohol use, and appearance-related distress among maxillofacial trauma outpatients over medium-term follow-up. It also explored socio-demographic and injury-related variables associated with psychological distress to inform targeted psychological screening protocols for maxillofacial trauma services. Significant associations were found between level of distress at time of injury and number of traumatic life events with levels of depression at 3 months. No significant associations were found between predictor variables and PTSD at 3 months, or with any psychiatric diagnosis at 6 months. The lack of evidence for an identifiable subgroup of patients who were at higher risk of psychological distress indicated that routine screening of all maxillofacial trauma outpatients should be offered in order to best respond to their mental health needs. The feasibility of the medical team facilitating this is challenging and should ideally be undertaken by psychologists integrated within the MDT. This study led to the funding of a clinical psychologist to provide collaborative care with the maxillofacial surgeons, resulting in brief assessment and treatment to over 600 patients in the first year of the service.

Efficacy and morbidity of biodegradable versus titanium osteosyntheses in orthognathic surgery: A systematic review with meta‐analysis and trial sequential analysis

“…Furthermore, trauma patients’ fractures are fixated into maximum occlusion whereas maximum occlusion in patients undergoing orthognathic surgery is reached after postoperative orthodontic treatment. Additionally, trauma patients are more often male using alcohol and tobacco compared to patients undergoing orthognathic surgery [ 80 , 81 , 82 ]. Both substances impair wound healing and reduce vascularity intra‐orally and thus disturb degradation and resorption of biodegradable systems.…”

Evaluation of Anxiety and Experience of patients presented with Maxillofacial Trauma in Nishtar Institute of Dentistry

“…A significant number of patients of facial trauma displayed psychological disorders in trauma as well as in follow up visits in OPD. Depression, anxiety related to facial appearance and PTSD were among the most common disorders 11 . Almost 39% patients of facial trauma met criteria of psychiatric illness when presented in trauma which shows a significant association which decreases to 27% in follow up visits as reported in literature 11 .…”

“…Depression, anxiety related to facial appearance and PTSD were among the most common disorders 11 . Almost 39% patients of facial trauma met criteria of psychiatric illness when presented in trauma which shows a significant association which decreases to 27% in follow up visits as reported in literature 11 . Disfigurement associated with facial injuries mainly affects the individuals self-esteem and personality and leads to psychological disorders 12 .…”

“…A study by Pokharel PK et al showed in their study that 41.3% of included patients in their study suffered from depression in post facial trauma period which reduced with time in follow up visits 18 . A study by Wilson N et al showed that 23% of post maxillofacial trauma patients suffered from post trauma stress disorder which gradually reduced in followup visits 11 . A study by Islam s et al don in Uk and Australia showed that post facial trauma depression was found in 20 % Uk and 11.5% of Australian included patients while anxiety was present in 20% Uk and 15% of patients included from Australia 19 .…”

Diagnosis and Treatment of Midface Trauma in the Context of Polytrauma: Characteristics during COVID-19 Pandemic Conditions

“…• Psychological support is compulsory in head and neck trauma cases, and the attending surgeon and specialized clinical psychologist should be involved or even psychiatric support in self-inflicted lesions [49].…”