The Development of Mental Health Problems in Patients with Polytrauma
27th December 2019
By Chelsea Hanna
Whilst a universal definition of poly-trauma remains largely ambiguous, it can be used to describe a patient who has at least two or more severe injuries in separate areas of the body and at least one of these endangers the life of the individual (Kroupa, 1990). Poly-trauma patients are thus difficult to manage, as Schuster puts “The management of a head injured patient with multiple other injuries presents one of the most challenging and difficult clinical scenarios in trauma critical care” (2010). This complexity in dealing with and treating poly-trauma and TBI patients raises a problem with regards to patient recovery and rehabilitation. Since the psychological effects of polytrauma continue to show 10 years from the time of injury they can have damaging long term effects on an individual’s quality of life (QoL). The management and rehabilitation of these patients should be considered in order to decipher the risk factors for any subsequent mental health problems.
Poor psychological and functional outcomes are evident in patients with TBI more than two years after injury (Gross, 2012). These factors may present as vulnerabilities to a mental health disorder. The long term outcomes of TBI in poly-trauma are still a relatively small area of study. Yet, from looking at the evidence it is important to assess these outcomes in order to minimise the impact or risk of psychological impairment. Ultimately this is helpful in understanding how this could be as a result of one of the steps taken in therapy or rehabilitation. One study highlights that physicians should not only focus on physical rehabilitation but also on early mental rehabilitation in order to prevent the long term outcomes of poly-trauma (Falkenberg et al., 2017). When looking at poly-trauma as a whole, a number of risk factors have been established which may contribute to the occurrence of a mental health disorder. One explanation of this is the unsatisfactory rehabilitation of a patient. Alternatively, the traumatic experience of an individual becoming injured predisposes them to disorders such as PTSD. These may highlight a gap in the long term care of poly-traumatised patients, which in turn, has the potential to result in mental health problems.
References:
https://link.springer.com/chapter/10.1007/978-0-387-89508-6_15
https://www.ncbi.nlm.nih.gov/pubmed/2239047
https://onlinelibrary.wiley.com/doi/pdf/10.1111/j.1399-6576.2012.02724.x