Article

Chronic pain, posttraumatic stress disorder (PTSD), and depression are
common outcomes following traumatic injury. Yet, screening and early intervention
to prevent the onset of these disorders do not occur routinely in acute trauma
settings. This pilot study examined the clinical utility of screening and early
multidisciplinary intervention for reducing disability following traumatic injury. METHOD: 142 non-severe head injured trauma inpatients (26% female, Injury
Severity Score M = 9.65, M age = 36 years) were assessed for injury-related
factors, pain, and psychological function within 4 weeks post injury. Patients
were randomly allocated to a Multidisciplinary Intervention (MI) or Usual Care
(UC) group. MI patients received assessment and treatment at one and 3 months
post injury from pain and rehabilitation medicine doctors, physiotherapists,
occupational therapists, and clinical psychologists. Outcomes at 6 months were
then compared. RESULTS: Acute pain intensity, posttraumatic adjustment,
depression and acute trauma symptoms, and alcohol use predicted a significant
26%, 49%, 56%, and 30% of the variance in pain, depressive, and PTSD severity,
and physical mobility respectively at 6 months. Despite MI group patients
reporting no improvement in the severity of pain and psychological symptoms,
these patients reported significantly improved relief from pain symptoms as a
result of treatment at 6 months. Twenty four per cent of the UC group initially
below the cut-off for being at risk of developing PTSD/Depression received new
clinical diagnoses at 6 months compared with none of the 'not at risk' MI group
attendees who remained asymptomatic. CONCLUSIONS: Early findings point to the
value of early screening to identify patients at risk of treatable pain,
physical, and psychological impairments. Moreover, early multidisciplinary
intervention models following traumatic injury show promise for protecting
against the onset of posttraumatic psychological disorders.

Langue : ANGLAIS