title: Chronic psychological and functional sequelae after emergent hand surgery.
abstract: OBJECTIVE
  Several studies have shown that upper extremity trauma has serious, acute psychological effects after injury. This study's goal was to assess the psychological outcomes, including symptoms of major depression, posttraumatic stress disorder (PTSD), and other psychosocial variables, as well as the Quick Disabilities of the Arm, Shoulder, and Hand (QuickDASH) results, after severe hand trauma. We hypothesized that hand trauma would have persistent psychological sequelae long after the physical injury.
  
  
  METHODS
  We performed a cross-sectional survey of 34 patients who had emergency hand surgery at a Level 1 trauma center an average of 16 months (range, 7-32 mo) earlier. The hand disability measure was the QuickDASH, and the psychological measures included the Center for Epidemiologic Studies Depression Scale, the Screen for Posttraumatic Stress Symptoms, the Medical Outcomes Study Social Support Survey Form, the Social Constraints Survey (to assess interpersonal stressors), and the Perceived Stress Scale.
  
  
  RESULTS
  The overall QuickDASH score was 27. The mean score for PTSD was 13 (above the clinical threshold for PTSD), and 29% of respondents had high levels of both depression and PTSD. High pain scores on the QuickDASH were strongly correlated with both depression and PTSD symptoms.
  
  
  CONCLUSIONS
  This study found high levels of psychological distress in patients after hand trauma. Hand disability was strongly related to pain, depression, and PTSD symptoms. This study shows that the psychological sequelae of hand trauma can persist long after the physical injury.
  
  
  METHODS
  Therapeutic IV.
authors.affiliation: Department of Surgery, Stanford University School of Medicine, Stanford, CA, USA.
authors.forename: Todd
authors.initials: T
authors.lastname: Richards
authors.forename: Donn W
authors.initials: DW
authors.lastname: Garvert
authors.forename: Elizabeth
authors.initials: E
authors.lastname: McDade
authors.forename: Eve
authors.initials: E
authors.lastname: Carlson
authors.forename: Catherine
authors.initials: C
authors.lastname: Curtin
mesh_terms: D000328:Adult; D003863:Depression / Q000175:diagnosis* / Q000209:etiology; D004185:Disability Evaluation; D004630:Emergencies / Q000523:psychology; D005260:Female; D006230:Hand Injuries / Q000503:physiopathology / Q000523:psychology* / Q000601:surgery*; D006801:Humans; D008297:Male; D013313:Stress Disorders, Post-Traumatic / Q000175:diagnosis / Q000209:etiology*; D013315:Stress, Psychological / Q000175:diagnosis / Q000209:etiology*; D011795:Surveys and Questionnaires