The impact of psychological factors on recovery from injury: a multicentre cohort study.
Unintentional injuries have a significant long-term health impact in working age adults. Depression, anxiety and post-traumatic stress disorder are common post-injury, but their impact on self-reported recovery has not been investigated in general injury populations. This study investigated the role of psychological predictors 1 month post-injury in subsequent self-reported recovery from injury in working-aged adults.



A multicentre cohort study was conducted of 668 unintentionally injured adults admitted to five UK hospitals followed up at 1, 2, 4 and 12 months post-injury. Logistic regression explored relationships between psychological morbidity 1 month post-injury and self-reported recovery 12 months post-injury, adjusting for health, demographic, injury and socio-legal factors. Multiple imputations were used to impute missing values.



A total of 668 adults participated at baseline, 77% followed up at 1 month and 63% at 12 months, of whom 383 (57%) were included in the main analysis. Multiple imputation analysis included all 668 participants. Increasing levels of depression scores and increasing levels of pain at 1 month and an increasing number of nights in hospital were associated with significantly reduced odds of recovery at 12 months, adjusting for age, sex, centre, employment and deprivation. The findings were similar in the multiple imputation analysis, except that pain had borderline statistical significance.



Depression 1 month post-injury is an important predictor of recovery, but other factors, especially pain and nights spent in hospital, also predict recovery. Identifying and managing depression and providing adequate pain control are essential in clinical care post-injury.
Division of Psychology, School of Social Sciences, Nottingham Trent University, Burton Street, Nottingham, NG1 4BU, UK. Blerina.kellezi@ntu.ac.uk.
Blerina
http://orcid.org/0000-0003-4825-3624
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Kellezi
Division of Primary Care, University of Nottingham, Floor 13, Tower Building, University Park, Nottingham, NG7 2RD, UK.
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C
Coupland
Division of Psychiatry and Applied Psychology, Institute of Mental Health and CLAHRC East Midlands, University of Nottingham, Nottingham, UK.
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R
Morriss
Education Centre, University of the West of England, Research and Innovation, University Hospitals Bristol NHS Foundation Trust, Upper Maudlin Street, Bristol, BS2 8AE, UK.
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K
Beckett
School of Education, University of Nottingham, Nottingham, NG8 1BB, UK.
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Joseph
Design School, Loughborough University, Ashby Road, Loughborough, LE11 3TU, UK.
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Barnes
Centre for Transport Studies, UCL, Gower Street, London, WC1E 6BT, UK.
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Christie
Department of Sociology, University of Surrey, Guildford, Surrey, GU2 7XH, UK.
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J
Sleney
Division of Primary Care, University of Nottingham, Floor 13, Tower Building, University Park, Nottingham, NG7 2RD, UK.
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Kendrick
D000293:Adolescent; D000328:Adult; D000368:Aged; D001007:Anxiety / Q000453:epidemiology; D015331:Cohort Studies; D003863:Depression / Q000453:epidemiology; D005260:Female; D006801:Humans; D008297:Male; D001523:Mental Disorders / Q000453:epidemiology*; D008875:Middle Aged; D012307:Risk Factors; D057566:Self Report; D013313:Stress Disorders, Post-Traumatic / Q000453:epidemiology; D006113:United Kingdom / Q000453:epidemiology; D014947:Wounds and Injuries / Q000523:psychology* / Q000534:rehabilitation*; D055815:Young Adult
Depression; Longitudinal; Psychological; Recovery; Unintentional injury