Psychosocial aspects of accidental injuries ? an overview

Abstract

This paper reviews the current "state of the art" with regard to psycho-traumatological issues in accidentally injured patients. A MEDLINE search (1985-1995) yielded a total of 135 references, out of which 60 publications were selected and reviewed. The body of knowledge about the psycho-social effects of serious injuries caused by accidents seems to be still limited. There are indications that accidents leave many patients suffering from not only the physical consequences but also considerable psychological problems. A frequent clinical manifestation of such problems is post-traumatic stress disorder (PTSD), but depression, anxiety and the somatoform disorder have also been observed, possibly even more frequently. There have been substantial discrepancies in epidemiological data in the literature, partially because the samples analyzed so far have not been homogeneous enough. It is also obvious that studies have been devoted almost exclusively to disorders and handicaps following (and occasionally prior to) the traumatic event. Seldom has the study focused on patient resources: practically no studies exist on the effects of protective psycho-social factors on the healing process following accidental injuries. More research is needed in order to be able to make predictions on the expected healing of patients during the acute stage of treatment following an accident. These future studies should deliver information on identifying high-risk patients who would require specific psycho-social intervention.

Antonovsky’s Sense of Coherence: Trait or State?

“…This would be in accordance with evidence from traumatic stress research, showing that a considerable proportion of accident victims may develop long-lasting psychosocial problems, with 8% of patients still suffering from chronic posttraumatic stress disorder 5 years after the accident [45, 46]. This second possible explanation would also allow for a better understanding of the early symptoms of depression and anxiety that decrease significantly during the first half year after the trauma: it could be argued that psychopathological symptoms reflect the early psychological reactions in the immediate aftermath of the trauma, while the delayed but permanent decrease in SOC scores reflects the longstanding changes in the patients’ world view as a consequence of the accident and its sequelae.…”