Abstract
BackgroundDepression is common among general trauma patients and is associated with a poor outcome. We evaluated the relationship of psychological distress to physical injury, musculoskeletal complaints, and social factors in a low-income country.MethodsWe administered the Self-Rating Questionnaire (SRQ), the Oslo social support questionnaire, and the Brief Disability Questionnaire (BDQ).ResultsAn SRQ score of 9 or more, which indicates probable depressive disorder, occurred in 45.6% of men and 76.1% of women. A high SRQ score was associated with female sex, little or no education, low income and little social support. Even after these were controlled for there was a significantly higher SRQ score in patients with arthritis, backache/prolapsed disc, major fracture and other bone pathology.ConclusionsDepressive disorder appears to be very common in orthopaedic outpatients in Pakistan; both social circumstances and nature of bone pathology are associated with such depression.
Highlights
Depression is common among general trauma patients and is associated with a poor outcome
Among men with medically unexplained symptoms 19/35 (54.3%) had an Self-Rating Questionnaire (SRQ) score of 9 or more compared with 172/373 (46.1%) of those with symptoms explained by organic pathology (χ2 = 0.868; P = 0.35)
These proportions are almost identical to those we recorded in a similar consecutive sample of patients attending medical clinics at the same hospital (47% of men and 63% of women) [18] and are much higher than those we previously found in a population-based sample in rural Pakistan (17.5% of men and 44.1% of women) [24]
Summary
Depression is common among general trauma patients and is associated with a poor outcome. Chronic pain is one of the most common presentations for healthcare and it is reported that such patients are five times more likely to utilise health than the general population [5,6]. Both regional (for example, in the limbs) and widespread pain are increased in people of Pakistani, Indian and Bangladeshi origin relative to the local white European population in the UK [7,8]
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