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Cited by 30Posttraumatic Stress Disorder ResearchMental Health Treatment and AccessChild and Adolescent Psychosocial and Emotional Development

Association Between Traumatic Injury and Psychiatric Disorders and Medication Prescription to Youths Aged 10–19

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Zatzick, Douglas F., Grossman, David C.·2011·Psychiatric Services
DOI 10.1176/ps.62.3.pss6203_0264PMC PMC3121256
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Abstract

OBJECTIVE: Few clinical epidemiologic investigations have assessed whether youths exposed to a traumatic injury demonstrate elevations in the full spectrum of provider-recognized psychiatric disorders compared with unexposed, noninjured youths. METHODS: In a population-based prospective cohort study, data for children and adolescents aged ten to 19 who were enrolled in the Group Health Cooperative health plan were screened for injury visits in the index year of 2001 (N=20,507). Psychiatric diagnoses, including anxiety and acute stress, depressive, substance use, and disruptive behavior disorders, given to these youths over the next three years (2002-2004) were documented, as were psychotropic medication prescriptions. Regression analyses assessed for an independent association between injury and psychiatric disorders and prescription of psychotropic medication. RESULTS: In adjusted regression analyses, injury in the index year was independently associated with significantly increased odds of receiving a diagnosis of anxiety or acute stress (odds ratio [OR]=1.21, 95% confidence interval [CI]=1.02-1.44), depression (OR=1.30, CI=1.10-1.53), and a substance use disorder (OR=1.56, CI=1.21-2.00) and of receiving a psychotropic medication prescription (OR=1.37, CI=1.20-1.57). Youths with traumatic brain injuries also were significantly more likely to receive psychotropic medication prescriptions. CONCLUSIONS: Traumatic injury was independently associated with an increased risk of receiving a full spectrum of anxiety, depressive, and substance use diagnoses among youths aged ten to 19. Population-based surveillance procedures that incorporate screening and stepped-care interventions targeting the spectrum of postinjury emotional disturbances have the potential to improve the quality of mental health care for youths treated in general medical settings.

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  • About 22% of traumatically injured patients develop a new psychiatric illness after injury.

    “While likely complex in association and causality, about 22% of traumatically injured patients develop a new psychiatric illness after traumatic injury, and 56% have an increased risk of developing a substance use disorder within 3 years of injury, both of which are significant risk factors for suicide [36, 37].”

    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 [37]

    The Discussion and Results (page numbers unavailable) report that injured youths aged 10–19 were more likely than uninjured youths to receive psychiatric diagnoses after injury. They do not report that 22% developed a new psychiatric illness, and the finding is specific to youths rather than traumatically injured patients generally. (LLM, conf=0.85)

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  • 56% of traumatically injured patients have an increased risk of developing a substance use disorder within 3 years of injury.

    “While likely complex in association and causality, about 22% of traumatically injured patients develop a new psychiatric illness after traumatic injury, and 56% have an increased risk of developing a substance use disorder within 3 years of injury, both of which are significant risk factors for suicide [36, 37].”

    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 [37]

    The Abstract Results report an adjusted odds ratio of 1.56 for a substance use disorder diagnosis after injury, and the Results place the elevated odds in the three years after injury. That is 56% higher odds among injured youths aged 10–19 compared with noninjured youths—not a finding that 56% of traumatically injured patients develop the disorder or have individually increased risk. (LLM, conf=0.90)

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1 of the 64 references couldn’t be matched to a known paper.

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  1. [51]Koepsell T Weiss N Studying the occurrence of illness Epidemiologic Methods 2003 New York Oxford University Press

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Authors
Zatzick, D. F., & Grossman, D. C.
Affiliations
  • University of Washington (US)
  • Kaiser Permanente Washington Health Research Institute (US)
ORCID
Zatzick, Douglas F.
Venue
Psychiatric Services
Publisher
American Psychiatric Association Publishing
Published
2011-03
Volume
62
Issue
3
Pages
264-271
ISSN
  • 0022-1597 (ISSN-L)
  • 1075-2730
  • 1557-9700
DOI
10.1176/ps.62.3.pss6203_0264
PMC
PMC3121256
OpenAlex
W2055272806
Cited by
30
References
64
Citations by year
2026: 1 · 2025: 3 · 2022: 3 · 2021: 5 · 2020: 2 · 2019: 4 · 2014: 1 · 2013: 7 · 2012: 4
FWCI
4.13
Type
journal article
Language
en
Open access
Locations
  • Psychiatric Services (publishedVersion)
  • PubMed (publishedVersion)
  • PubMed Central (acceptedVersion)
Funders
  • National Institutes of Health (5r01mh073613-05, 5k24mh086814-05)
  • Centers for Disease Control and Prevention
  • U.S. Public Health Service (R49/CCR316840)
  • National Institute of Mental Health (R01/MH073613, K24/MH086814, K24-MH086914)
  • National Center for Injury Prevention and Control
Topics
  • Social Sciences › Psychology › Clinical Psychology › Posttraumatic Stress Disorder Research
  • Social Sciences › Psychology › Social Psychology › Mental Health Treatment and Access
  • Social Sciences › Psychology › Clinical Psychology › Child and Adolescent Psychosocial and Emotional Development
Keywords
traumatic injury, mental illness, adolescents, psychotropic drugs, anxiety disorders, depression, substance use disorders, traumatic brain injury, disruptive behavior disorders, mental health services
MeSH terms
Adolescent, Child, Female, Humans, Male, Drug Prescriptions, Prospective Studies, Stress Disorders, Post-Traumatic, Wounds and Injuries, Cohort Studies, Confidence Intervals, Pacific States, Young Adult

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