[Abstract] Systematic review: Predicting adverse psychological outcomes after hand trauma

Abstract

Study Design

Systematic review.

Introduction and Purpose of the Study

After traumatic hand injury, extensive physical and psychological adaptation is required following surgical reconstruction. Recovery from injury can understandably be emotionally challenging, which may result in impaired quality of life and delayed physical recovery. However, the evidence base for identifying high-risk patients is limited.

Methods

A PROSPERO-registered literature search of MEDLINE (1946-present), EMBASE (1980-present), PsychInfo, and CINAHL electronic databases identified 5156 results for studies reporting psychological outcomes after acute hand trauma. Subsequent review and selection by 2 independent reviewers identified 19 studies for inclusion. These were poor quality level 2 prognostic studies, cross sectional or cohort in design, and varied widely in methodology, sample sizes, diagnostic methods, and cutoff values used to identify psychological symptoms. Data regarding symptoms, predisposing factors, and questionnaires used to identify them were extracted and analyzed.

Results

Patients with amputations or a tendency to catastrophize suffered highest pain ratings. Persisting symptom presence at 3 months was the best predictor of chronicity. Many different questionnaires were used for symptom detection, but none had been specifically validated in a hand trauma population of patients. Few studies assessed the ability of selection tools to predict patients at high risk of developing adverse psychological outcomes.

Discussion and Conclusion

Despite a limited evidence base, screening at 3 months may detect post-traumatic stress disorder, anxiety, depression, and chronic pain, potentially allowing for early intervention and improved treatment outcomes.

Source: Systematic review: Predicting adverse psychological outcomes after hand trauma – Journal of Hand Therapy

 

[ARTICLE] The Prevalence of Personality Disorder in Hand and Upper Extremity Trauma – Full Text

Abstract

Background: Upper extremity is the most common part of the body, which is exposed to injuries with physical, mental, social and economic consequences.

Objectives: This research studied the prevalence and types of personality disorders in patients with upper extremity trauma at Hazrat Fatima hospital.

Methods: This research studied all patients with upper extremity trauma in a three-month period hospitalized at Hazrat Fatemeh. The Millon Test was filled by all candidates with a clinical psychologist and psychometric supervision. Results were analyzed statistically.

Results: This study included 202 male participants with age range of 14 to 70 years old, amongst whom 41.4% had personality disorders. The prevalence of personality disorder in violence and self-injury groups was 72.7% and 39.3% in the group of industrial accidents, which proved a significant difference (P = 0.003). Avoidant personality disorders (P = 001), narcissistic (P = 0.003), anti-social (P = 0.002), borderline (P = 0.001) passive aggressive (P = 0.002) were significantly more common in violence and self-injury group.

Conclusions: The present study revealed that the prevalence of personality disorder in patients with upper extremity injuries is more than the society. Due to the high rate of personality disorder in hand trauma victims, we recommended routine psychological evaluation of these patients.

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