Prevalence of post traumatic stress disorder and associated factors in adult orthopaedic trauma patients seen at Mulago Hospital, Kampala Uganda.

Abstract

Background Attempts to ensure total care of the trauma patient in order to reduce morbidity and mortality, has led to a drift of global concern towards the psychiatric sequelae of trauma patients. Psychiatric disorders following trauma are common with one of the commonest being post- traumatic stress disorder (PTSD) and are associated with poor functional and occupational outcomes. The prevalence of PTSD in orthopaedic trauma patients vary from place to place. Studies in United States, Kenya and Nigeria had 51, 13.3 and 26.7% of patients fulfilling the criteria for PTSD . No similar studies have been carried out in Uganda. PTSD in orthopaedic trauma patients causes unique problems for patients ranging from depression, anxiety, pain or sleep problems that may be more challenging than their orthopaedic trauma. Objective To determine the prevalence and associated factors of post- traumatic stress disorder in adult orthopaedic trauma patients seen at Mulago hospital. Methodology This was a hospital based cross-sectional descriptive study of adult orthopaedic trauma patients at Mulago hospital. A structured questionnaire containing injury characteristics and module for PTSD diagnosis in Diagnostic and Statistical Manual Fourth Edition Text Revised (DSM-IV-TR) was administered to consenting patients who met the inclusion criteria by systematic random sampling. Data was entered in Epi Data software and exported to STATA 10.0 for Univariate, bivariate and multivariate analysis using Mantel Haenszel method and logistic regression model. Results Two hundred and ninety seven (297) patients were recruited into the study of which the prevalence of PTSD in adult orthopaedic trauma patients seen at Mulago hospital was 17.85%(53/297). Spine injuries, duration of injury>12 months, presence of death in an accident and absence of alcohol consumption were associated with post traumatic stress disorder after bivariate analysis (p <0.05). Multivariate logistic regression showed - 2 presence of death in an accident and absence of alcohol consumption to be significantly associated with post traumatic stress disorder after adjusted for spine injury and duration of injury > 12 months. Conclusion The prevalence of PTSD in adult orthopaedic trauma patients in Mulago Hospital is 17.85%.Therefore there is the need for collaboration between Psychiatrists and Orthopaedic Surgeons in the management of these patients to ensure a better functional, occupational and psychological outcome.