title: Association between traumatic injury and psychiatric disorders and medication prescription to youths aged 10-19.
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.
authors.affiliation: Department of Psychiatry and Behavioral Sciences, University of Washington Harborview Medical Center, 325 9th Ave., Seattle, WA 98104-2499, USA. dzatzick@u.washington.edu
authors.forename: Douglas F
authors.initials: DF
authors.lastname: Zatzick
authors.forename: David C
authors.initials: DC
authors.lastname: Grossman
mesh_terms: D000293:Adolescent; D002648:Child; D015331:Cohort Studies; D016001:Confidence Intervals; D011307:Drug Prescriptions; D005260:Female; D006801:Humans; D008297:Male; D019601:Pacific States; D011446:Prospective Studies; D013313:Stress Disorders, Post-Traumatic / Q000188:drug therapy* / Q000209:etiology*; D014947:Wounds and Injuries / Q000150:complications* / Q000523:psychology; D055815:Young Adult