The combination of both afflictions increases the incidence of somatic
complaints, although this is not the case for either condition standing
alone, say Douglas F. Zatzick, M.D., and colleagues from the University
of Washington School of Medicine. Psychosomatic symptoms are physical complaints
that cannot be medically explained.
The research findings appear in the November-December issue of the journal
Psychosomatics.
Each year, about 2.6 million Americans require hospitalization after suffering
traumatic physical injuries. Between 10 percent and 40 percent experience
post-traumatic stress disorder (PTSD) in the year following injury, says
Zatzick.
Zatzick and colleagues interviewed 73 randomly selected patients who agreed
to be tested. The patients were hospitalized after emergency trauma surgery
for intentional and unintentional injuries. Researchers tested them for
physical symptoms, post-traumatic stress symptoms and depressive symptoms.
They also recorded the severity of injuries, the part of the body injured
and other medical conditions that might have affected recovery.
While in the surgical ward, 31 percent of the patients scored high enough
for a PTSD diagnosis and 42 percent had high depressive scores. A year
later, those patients who had both higher depression and higher PTSD reported
significantly higher levels of physical distress that could not be attributed
to medical conditions. Women were also more likely than men to report such
symptoms.
These patients also had used the health care system heavily in the subsequent
12 months but less often for their psychological well-being.
Knowing which patients had symptoms of PTSD and depression in the inpatient
surgical unit and other acute care settings such as the emergency room
might stimulate treatment and lessen the occurrence of future psychosomatic
symptoms, the researchers suggest.
“The discussion of symptoms with pragmatically oriented trauma center
providers may facilitate early mental health screening and intervention
procedures targeting the complexity of PTSD and depression, and somatic
amplification,” Zatzick says. “Similarly, mental health professionals
working in the acute care medical setting may be able to identify patients
who are amplifying somatic complaints.”
The National Institute of Mental Health provided funding for this project.
