title: Psychological Distress following Injury in a Large Cohort of Thai Adults.
abstract: BACKGROUND
  Injury and psychological distress are public health priorities because of their high occurrence in the population. This study examines the longitudinal effects of injury characteristics on psychological distress.
  
  
  METHODS
  Study participants were enrolled distance learning Thai adults (N = 42,785 at 2013 follow-up) residing nationwide. We analysed 2009 and 2013 data. Injury questions included injury prevalence, causes and levels of severity. Distress was measured using the standard Kessler-6. To assess the risk for post-injury distress, we used multinomial logistic regression investigating psychological distress in 2013 as an outcome including injury categories in both 2009 and 2013 as predictors, adjusted for sociodemographic factors.
  
  
  RESULTS
  Overall injury was predictive of psychological distress. Both types of injury (traffic and non- traffic) associated with increasing psychological distress. Those that had experienced both types of injuries in the previous year had higher odds of developing psychological distress compared to those who experienced just one type. In 2013, adjusted psychological distress odds ratios were 1.46 [95% Confidence Interval 1.14-1.87] for traffic injury only; 1.26 [1.13-1.40] for non-traffic injury only; and 2.71 [2.19-3.35] for both traffic and non-traffic injuries. Increasing frequency of injury and increasing injury severity were also linked to elevated psychological distress among our Thai cohort members.
  
  
  CONCLUSIONS
  Our results revealed a significantly high risk of psychological distress following injury. With increasing occurrence of injury, especially traffic injuries in low and middle income countries such as Thailand, future policies should not only focus on physical care but also address psychological distress as an important consequence of injury.
authors: Department of Global Health and National Centre for Epidemiology and Population Health, Research School of Population Health, ANU College of Medicine, Biology and Environment, The Australian National University, Canberra, Australia.
authors: Thanh Tam
authors: http://orcid.org/0000-0002-7489-3126
authors: TT
authors: Tran
authors: The Australian National University Medical School, Canberra, Australia.
authors: Joel
authors: J
authors: Adams-Bedford
authors: Centre for Research on Ageing, Health and Wellbeing, Research School of Population Health, ANU College of Medicine, Biology and Environment, The Australian National University, Canberra, Australia.
authors: Vasoontara
authors: V
authors: Yiengprugsawan
authors: School of Human Ecology, Sukhothai Thammathirat Open University, Nonthaburi, Thailand.
authors: Sam-Ang
authors: SA
authors: Seubsman
authors: Department of Global Health and National Centre for Epidemiology and Population Health, Research School of Population Health, ANU College of Medicine, Biology and Environment, The Australian National University, Canberra, Australia.
authors: Adrian
authors: A
authors: Sleigh
mesh_terms: D000063:Accidents, Traffic / Q000523:psychology; D000328:Adult; D015331:Cohort Studies; D005260:Female; D006292:Health Priorities; D006801:Humans; D008297:Male; D008875:Middle Aged; D013315:Stress, Psychological / Q000453:epidemiology*; D013785:Thailand / Q000453:epidemiology; D014947:Wounds and Injuries / Q000523:psychology*