Proinflammatory markers in prediction of posttraumatic psychological symptoms: a prospective cohort study.
BACKGROUND
Posttraumatic psychopathology (PTP) describes the spectrum of conditions that can complicate the recovery from commonly occurring musculoskeletal trauma. There is a clear association with the activation of the hypothalamic-pituitary-adrenal axis (HPAA), and we wished to examine the predictive value of proinflammatory markers of the HPAA and of the GABA, which acts as an inhibitory regulator.


METHODS
Levels of proinflammatory markers and GABA were measured in 84 patients who had suffered musculoskeletal injuries requiring hospitalisation. PTP was assessed by the use of the General Health Questionnaire (GHQ) at presentation and again at two- and six-month reviews.


RESULTS
Significant psychological disturbance was noted in 39% of patients at two months and falling back to 18% by six months. There was no correlation between any of the markers tested at presentation and PTP at follow-up.


CONCLUSIONS
The HPAA response to trauma and the development of PTP are extremely complex. It is unlikely that a simple blood assay will provide significant predictive information, while incident specific information and patient perception are of more practical use.
Sutherland
Alasdair George
AG
Department of Orthopaedics, School of Medicine and Dentistry, University of Aberdeen, Scotland, UK. ort025@abdn.ac.uk
Cameron
Gary A
GA
Alexander
David A
DA
Hutchison
James D
JD
D000293:Adolescent; D000328:Adult; D000368:Aged; D015415:Biomarkers / Q000378:metabolism*; D006801:Humans; D007249:Inflammation / Q000378:metabolism*; D008297:Male; D008875:Middle Aged; D009140:Musculoskeletal Diseases / Q000276:immunology* / Q000473:pathology / Q000503:physiopathology / Q000523:psychology*; D009141:Musculoskeletal System / Q000276:immunology / Q000293:injuries; D011446:Prospective Studies; D013313:Stress Disorders, Post-Traumatic / Q000276:immunology* / Q000503:physiopathology / Q000523:psychology; D011795:Surveys and Questionnaires; D055815:Young Adult
D015415:Biomarkers