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

Supa Pengpid,Karl Peltzer

doi:10.1186/s40359-020-00501-6

Abstract

BackgroundEvidence 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.MethodsIn 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.ResultsThe 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.ConclusionCompared 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.

Highlights

Evidence of the relationship between serious physical injury and poor mental health among university students from low- and middle-income countries is limited
Descriptive statistics The sample consisted of 18,382 university students (20 years median age, Interquartile range (IQR) = 19–22), 58.7% were females, 53.6% rated their wealth status as high, 65.7% received high social support, 11.9% were heavy alcohol users and 53.5% lived in low- or lower middle-income countries
The overall prevalence of past 12-month injuries was 24.7%, which was higher among male students, those residing in upper middle- or high-income countries, those who had low social support, and those who engaged in heavy alcohol use

Summary

Introduction

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. Depression and anxiety disorders, including posttraumatic stress disorder (PTSD), are one of the main causes of disability worldwide, in particular in low- and middle-income countries [1, 2]. There seems to be a lack of research among university students, in particular in low- and middleincome countries, on the association between injury, PTSD and depression symptoms. In a study among adults in 40 low- and middle-income countries, the pooled odds ratio (OR) for depression was 2.04 for other injuries and 1.72 for traffic injury [11]. Based on a study among predominantly older adults in six low- and middle-income countries, the prevalence of past 12-month depression was significantly higher among persons who had any past 12-month injury compared to those without injuries [12], and in an adolescent school survey in 21 low- and middle-income countries, the pooled OR for the association of past 12-month physical injury and past 12-month depressive symptoms was 1.83 [13]

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