title: Psychological distress among patients of an orthopaedic outpatient clinic: a study from a low-income country.
abstract: BACKGROUND
  Depression is common among general trauma patients and is associated with a poor outcome. We evaluated the relationship of psychological distress to physical injury, musculoskeletal complaints, and social factors in a low-income country.
  
  
  METHODS
  We administered the Self-Rating Questionnaire (SRQ), the Oslo social support questionnaire, and the Brief Disability Questionnaire (BDQ).
  
  
  RESULTS
  An SRQ score of 9 or more, which indicates probable depressive disorder, occurred in 45.6% of men and 76.1% of women. A high SRQ score was associated with female sex, little or no education, low income and little social support. Even after these were controlled for there was a significantly higher SRQ score in patients with arthritis, backache/prolapsed disc, major fracture and other bone pathology.
  
  
  CONCLUSIONS
  Depressive disorder appears to be very common in orthopaedic outpatients in Pakistan; both social circumstances and nature of bone pathology are associated with such depression.
authors.affiliation: University of Manchester, Manchester, UK.|Lancashire Care NHS Foundation Trust, Preston, UK.
authors.forename: Nusrat
authors.initials: N
authors.lastname: Husain
authors.affiliation: Dow University of Health Sciences, Karachi, Pakistan.
authors.forename: Syed M
authors.initials: SM
authors.lastname: Humail
authors.affiliation: University of Manchester, Manchester, UK.|Lancashire Care NHS Foundation Trust, Preston, UK.
authors.forename: Imran B
authors.initials: IB
authors.lastname: Chaudhry
authors.affiliation: Dow University of Health Sciences, Karachi, Pakistan.
authors.forename: Raza
authors.initials: R
authors.lastname: Rahman
authors.affiliation: University of Manchester, Manchester, UK.
authors.forename: Holly
authors.initials: H
authors.lastname: Robinson
authors.affiliation: University of Manchester, Manchester, UK.
authors.forename: Francis
authors.initials: F
authors.lastname: Creed