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The Mind Does Matter: Psychological and Physical Recovery After Musculoskeletal Trauma

Sutherland, Alasdair George MD, FRCS; Alexander, David A. PhD, FRCP; Hutchison, James D. PhD, FRCS

Journal of Trauma-Injury Infection & Critical Care: December 2006 - Volume 61 - Issue 6 - pp 1408-1414
doi: 10.1097/01.ta.0000197562.34651.df
Original Articles

Background: Posttraumatic psychopathology (PTP) is important to the orthopedic surgeon because it appears to be much more common than might have been suspected and may complicate the recovery from musculoskeletal injury. We have investigated the relationship between physical and psychological recovery in victims of musculoskeletal trauma.

Methods: A prospective cohort of 200 patients with musculoskeletal injuries were studied, correlating development of psychopathology (measured by the General Health Questionnaire) and functional outcome (measured by Short Form-36, Sickness Impact Profile, and Musculoskeletal Function Assessment) 2 and 6 months after their injuries.

Results: Pre-existing psychological disturbance was found in 11% of our patients; this figure rose to 46% of patients at 2 months but fell to 22% at 6 months. The posttraumatic disturbance correlated strongly with impaired functional outcome as measured by all three outcomes measures (total and category scores) (p < 0.05).

Conclusions: The strong correlation of PTP with impaired functional outcome after musculoskeletal trauma stresses that it is a significant problem. Further research is required to determine whether an approach that combines physical and psychological treatment can improve patient outcomes.

From the Departments of Orthopaedics (A.G.S., J.D.H.) and Mental Health (D.A.A.), University of Aberdeen Medical School and Aberdeen Centre for Trauma Research, Aberdeen, Scotland.

Submitted for publication April 26, 2005.

Accepted for publication October 7, 2005.

Supported by: Tenovus Scotland Grant G99/3, Scottish Executive Chief Scientist Office Mini Project Grant, and the Royal College of Surgeons Edinburgh Project Grant.

Presented to the Annual Congress of Australian Orthopaedic Association, October 2002, Melbourne, Australia.

Address for reprints: A.G. Sutherland, Department of Orthopedics, Polwarth Building, Foresterhill, Aberdeen AB25 2ZD, Scotland; email

© 2006 Lippincott Williams & Wilkins, Inc.