Prevalence and association of depression in in-patient orthopaedic trauma patients: A single centre study in India

Abstract

IntroductionDepression is characterized by a persistent state of low mood and aversion to activity affecting a person’s thoughts, behavior, feelings and sense of well-being. It has been reported in Orthopaedic trauma patients. Depression is likely to interfere in an individual’s ability to sustain a long duration rehabilitation programme leading to poor function and delayed return to a productive lifestyle. The objective of this study was to identify the prevalence and identify factors associated with depression in indoor Orthopaedic trauma patients. MethodsThis prospective cohort study was conducted on 190 adult Orthopaedic trauma patients enrolled on a randomly selected day of a week subject to written informed consent. Patients with conditions that may preclude assessment of the mental status were excluded from the study. Age, sex, duration since injury, Injury Severity Score (ISS), type of surgery, marital status, insurance coverage, level of education, socioeconomic status, familial support, substance abuse. Hospital anxiety and depression scale (HADS) score and pain score (visual analogue scale) were recorded as soon as the patient was stabilized. Bivariate analyses and Logistic regression were used to identify factors associated with a HADS score of ≥8. ResultsMean age was 33.8 years. One hundred fifty-one (79.47%) patients were males and thirty-nine patients were females (21.53%). A HADS score ≥8 was present in 42.63% enrolled cases. On logistic regression a higher pain score, nuclear family, and female sex were found to be significantly associated with HADS ≥8. ConclusionDepression is common in indoor Orthopaedic trauma patients. HADS may be used to screen patients for depression and refer patients to a psychiatrist for a definitive diagnosis and management.