The mind does matter: Psychological and physical recovery after musculoskeletal trauma.
BACKGROUND
Posttraumatic psychopathology (PTP) is important to the orthopedic surgeon because it appears to be much more common than might have been suspected and may complicate the recovery from musculoskeletal injury. We have investigated the relationship between physical and psychological recovery in victims of musculoskeletal trauma.


METHODS
A prospective cohort of 200 patients with musculoskeletal injuries were studied, correlating development of psychopathology (measured by the General Health Questionnaire) and functional outcome (measured by Short Form-36, Sickness Impact Profile, and Musculoskeletal Function Assessment) 2 and 6 months after their injuries.


RESULTS
Pre-existing psychological disturbance was found in 11% of our patients; this figure rose to 46% of patients at 2 months but fell to 22% at 6 months. The posttraumatic disturbance correlated strongly with impaired functional outcome as measured by all three outcomes measures (total and category scores) (p < 0.05).


CONCLUSIONS
The strong correlation of PTP with impaired functional outcome after musculoskeletal trauma stresses that it is a significant problem. Further research is required to determine whether an approach that combines physical and psychological treatment can improve patient outcomes.
Sutherland
Alasdair George
AG
Department of Orthopaedics, University of Aberdeen Medical School and Aberdeen Centre for Trauma Research, Aberdeen, Scotland. ort025@abdn.ac.uk
Alexander
David A
DA
Hutchison
James D
JD
D000293:Adolescent; D000328:Adult; D000368:Aged; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D015601:Injury Severity Score; D008297:Male; D001523:Mental Disorders / Q000209:etiology*; D008875:Middle Aged; D009141:Musculoskeletal System / Q000293:injuries*; D017063:Outcome Assessment, Health Care; D011446:Prospective Studies; D020127:Recovery of Function / Q000502:physiology*; D014947:Wounds and Injuries / Q000503:physiopathology* / Q000523:psychology*