title: Higher psychological distress is associated with unintentional injuries in US adults.
abstract: BACKGROUND
  Links between mental illness, self-inflicted injury and interpersonal violence are well recognised, but the association between poor mental health and unintentional injuries is not well understood.
  
  
  METHODS
  We used the 2010 National Health Interview Survey to assess the association between psychological distress and unintentional non-occupational injuries among US adults. Psychological distress was measured by the Kessler Psychological Distress Scale, a symptom scale shown to identify community-dwelling persons with mental illness. Multivariable logistic regression was used to estimate adjusted ORs (AOR) and 95% CIs.
  
  
  RESULTS
  Of the 26,776 individuals analysed, 2.5% reported a medically attended unintentional injury in the past 3 months. Those with moderate and severe psychological distress had 1.5 (1.2 to 1.8) and 2.0 (1.4 to 2.8) times higher odds of injury, respectively, as compared to those with low distress levels, after adjusting for age, sex, race, marital status, education level, alcohol use, physical functional limitation, medical comorbidity, employment status and health insurance status. Psychological distress was significantly associated with falls (AOR 1.4 (1.1 to 1.9)) and sprain/strain injuries (AOR 2.0 (1.5 to 2.8)), but not transportation-related injuries (AOR 1.2 (0.7 to 1.9)) or fractures (AOR 1.1 (0.8 to 1.6)).
  
  
  CONCLUSIONS
  Among community-dwelling US adults, psychological distress is significantly associated with unintentional non-occupational injury, and the magnitude of association increases with severity of distress. The association between psychological distress and injury may be particularly strong for falls and sprain/strain injuries. These findings draw attention to a large group of at-risk individuals that may merit further targeted research, including longitudinal studies.
authors.affiliation: Department of Epidemiology and Public Health, University of Maryland Baltimore School of Medicine, Baltimore, Maryland, USA.
authors.forename: Jana
authors.initials: J
authors.lastname: McAninch
authors.affiliation: Department of Epidemiology and Public Health, University of Maryland Baltimore School of Medicine, Baltimore, Maryland, USA.
authors.forename: Christina
authors.initials: C
authors.lastname: Greene
authors.affiliation: Baltimore VA Medical Center, Geriatrics Research, Education, and Clinical Center, Baltimore, Maryland, USA University of Maryland School of Medicine Claude D. Pepper Older Americans Independence Center, Baltimore, Maryland, USA.
authors.forename: John D
authors.initials: JD
authors.lastname: Sorkin
authors.affiliation: Department of Epidemiology and Public Health, University of Maryland Baltimore School of Medicine, Baltimore, Maryland, USA.
authors.forename: Marie-Claude
authors.initials: MC
authors.lastname: Lavoie
authors.affiliation: Department of Epidemiology and Public Health, University of Maryland Baltimore School of Medicine, Baltimore, Maryland, USA Shock, Trauma and Anesthesiology Research (STAR)-Organized Research Center, University of Maryland Baltimore, Baltimore, Maryland, USA.
authors.forename: Gordon S
authors.initials: GS
authors.lastname: Smith
mesh_terms: D000059:Accidents / Q000523:psychology*; D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D015331:Cohort Studies; D005260:Female; D006306:Health Surveys; D006801:Humans; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D012307:Risk Factors; D013315:Stress, Psychological / Q000209:etiology*; D014481:United States; D014947:Wounds and Injuries / Q000523:psychology*; D055815:Young Adult
keywords: Injury Diagnosis; Risk/Determinants