Screening and treating hospitalized trauma survivors for posttraumatic stress disorder and depression
Open accessAbstract
Traumatic injury affects over 2.6 million U.S. adults annually and elevates risk for a number of negative health consequences. This includes substantial psychological harm, the most prominent being posttraumatic stress disorder (PTSD), with approximately 21% of traumatic injury survivors developing the disorder within the first year after injury. Posttraumatic stress disorder is associated with deficits in physical recovery, social functioning, and quality of life. Depression is diagnosed in approximately 6% in the year after injury and is also a predictor of poor quality of life. The American College of Surgeons Committee on Trauma suggests screening for and treatment of PTSD and depression, reflecting a growing awareness of the critical need to address patients' mental health needs after trauma. While some trauma centers have implemented screening and treatment or referral for treatment programs, the majority are evaluating how to best address this recommendation, and no standard approach for screening and treatment currently exists. Further, guidelines are not yet available with respect to resources that may be used to effectively screen and treat these disorders in trauma survivors, as well as who is going to bear the costs. The purpose of this review is: (1) to evaluate the current state of the literature regarding evidence-based screens for PTSD and depression in the hospitalized trauma patient and (2) summarize the literature to date regarding the treatments that have empirical support in treating PTSD and depression acutely after injury. This review also includes structural and funding information regarding existing postinjury mental health programs. Screening of injured patients and timely intervention to prevent or treat PTSD and depression could substantially improve health outcomes and improve quality of life for this high-risk population. LEVEL OF EVIDENCE: Review, level IV.
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Step-up PTSD screening and mental health care models have the potential to improve support for pediatric and adult trauma patients, adapt to trauma centers with varying resources, and extend services via telehealth to address mental healthcare barriers.
“Step-up models of care for PTSD screening and mental health care have the potential to improve mental health support for pediatric and adult trauma patients, be adapted to meet the needs of trauma centers with varying resources, and extend services via telehealth to address barriers to mental healthcare [93, 94•, 95].”
From Adolescent Suicide—Understanding Unique Risks and Opportunities for Trauma Centers to Recognize, Intervene, and Prevent a Leading Cause of Death (2022) · cites this paper as [95]
The Stepped Collaborative Care Models section describes potential mental-health benefits after traumatic injury; Program funding and creative solutions discusses adapting care to centers’ resources; and Telehealth care’s role in improving access to care describes addressing mobility and geographic barriers. The review specifies adult traumatic-injury populations in Screens for the hospitalized injured population, so it does not establish the claim’s extension to pediatric patients. Page numbers were not supplied in our copy. (LLM, conf=0.87)
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Cited by
Sorted by citations
Hink, A. B., Killings, X., Bhatt, A., Ridings, L. E., & Andrews, A. L. (2022) · Current Trauma Reports · doi:10.1007/s40719-022-00223-7 · Cited by 67 · see citing works
- Authors
- deRoon-Cassini, T. A., Hunt, J. C., Geier, T. J., Warren, A. M., Ruggiero, K. J., Scott, K., George, J., Halling, M., Jurkovich, G., Fakhry, S. M., Zatzick, D., & Brasel, K. J.
- Affiliations
- Medical College of Wisconsin (US)
- Baylor University Medical Center (US)
- Medical University of South Carolina (US)
- University of Florida (US)
- Parkland Health & Hospital System (US)
- UC Davis Health (US)
- University of Washington (US)
- Oregon Health & Science University (US)
- ORCID
- Venue
- Journal of Trauma and Acute Care Surgery
- Published
- 2019-05-17
- Volume
- 87
- Issue
- 2
- Pages
- 440-450
- ISSN
- 2163-0755 (ISSN-L)
- 2163-0763
- PMC
- PMC6668348
- OpenAlex
- W2945087233
- Cited by
- 108
- References
- 70
- Citations by year
- 2026: 14 · 2025: 18 · 2024: 24 · 2023: 22 · 2022: 16 · 2021: 10 · 2020: 1 · 2019: 1 · 2018: 1
- FWCI
- 1.10
- Type
- journal article
- Language
- en
- Open access
- green
- www.ncbi.nlm.nih.gov
- Locations
- The Journal of Trauma: Injury, Infection, and Critical Care (publishedVersion)
- PubMed (publishedVersion)
- PubMed Central (acceptedVersion)
- eScholarship (California Digital Library) (submittedVersion)
- Funders
- National Institute of Mental Health (R21MH102838)
- Topics
- Social Sciences › Psychology › Clinical Psychology › Posttraumatic Stress Disorder Research
- Health Sciences › Medicine › Epidemiology › Traumatic Brain Injury Research
- Health Sciences › Medicine › Emergency Medicine › Trauma and Emergency Care Studies
- Keywords
- post-traumatic stress disorder, depression, trauma survivors, hospitalized patients, PTSD screening, depression screening, PTSD treatment, depression treatment, trauma centers, quality of life, mental health services funding
- MeSH terms
- Depression, Hospitalization, Humans, Mass Screening, Stress Disorders, Post-Traumatic, Wounds and Injuries, Survivors
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