Psychopathology and accidental injuries

Abstract

One hundred and twelve adults admitted to a surgical ward due to accidental injuries were studied. Thirty-seven percent had a psychiatric disorder on admission (DSM-III axis I) and 21% had a personality disorder (axis 2). Substance abuse and dependence and antisocial personality disorders were most frequent. Eighteen percent were definitely distressed when injured. Persons with a personality disorder were distressed significantly more often and had sustained clinically more severe injuries. No support could be found for a hypothesis of accidental injuries being the result of hidden or unconscious self-destructive tendencies, and only one patient was injured in a suicide attempt. Defense Mechanism Test applied to a subgroup of 20 patients suggested that high perceptual defense may be related to injury occurrence in patients at fault for the accident.

Characteristics of repeat trauma patients, San Diego County.

“…This rate is low in comparison with the 6% to 44% rate reported in other studies addressing recurrent trauma. 21 injured outside of the county would also result in underestimation of the rate of repeat trauma. Beyond the lower than expected prevalence of repeat trauma, several other findings in this study stand out.…”

Predictors of suicidal ideation, suicide attempts, and self-harm without lethal intent in a community corrections sample

“…Existing literature suggests that individuals with substance use disorders and antisocial personality have higher numbers of accidental injuries and poorer health status than the general population (Farrington, 1995;Malt, Myhrer, Blikra, & Hoivik, 1987; McGinnis & Foege, 1999; J. Shepherd, Farrington, & Potts, 2002;J. P. Shepherd, I. Shepherd, Newcombe, & Farrington, 2009;Valliant, 1973).…”

Psychiatric aspects of road traffic accidents

“…A fifth were 'definitely distressed' at the time of the accident. Psychiatric disorders, such as affective disorder (depression and mania) and schizophrenia, are occasional direct causes of road accidents (Noyes, 1985;Cremona, 1986;Malt et al, 1987;Tsuang, Boor & Fleming, 1985). Suicide and risk taking suicidal behaviour have been reported as being uncommon, nonetheless they are common enough to be a cause for considerable concern (Malt et al, 1987;Tsuang et al, 1985).…”

“…Amongst victims of accidents of all types, premorbid psychiatric disorder has been found to be more common in the general population, with a marked excess of personality disorder and substance abuse. For example, Malt (Malt et al, 1987) interviewed 112 admissions to surgical ward following an accident and classified 37% as having an Axis I DSM-111-R disorder (almost a half substance use disorders) and 21% as many as Axis I1 disorder for the two weeks prior to the accident. A fifth were 'definitely distressed' at the time of the accident.…”