Relationship between disability and pain to post-traumatic stress disorder, depression, and anxiety in patient with postoperative brachial plexus injury (BPI)

Abstract

Background: Orthopedic trauma patients have the risk to experience mental disorders, including depression, anxiety, post-traumatic stress disorder (PTSD), and other mental disorders. However, studies that analyze the relationship between mental disorders in orthopedic trauma patients, especially post-operative brachial plexus injury (BPI), are still difficult to find. This study aims to evaluate the relationship between disability and pain to post-traumatic stress disorder, depression, and anxiety in patient with postoperative BPI.

Materials and methods: It was an observational analysis with cross-sectional design study. Data were collected from July 2019 to September 2019. All subjects were patients of Orthopedics Clinic Dr. Soetomo General Academic Hospital Surabaya. The Disabilities of the Arm, Shoulder, and Hand (DASH) score was used to determine the disability level in patients. Visual Analog Score (VAS) was an instrument for assessing pain scale and mental disorders used Mini International Psychiatry Interview (MINI).

Results: There were 41 subjects met the research criteria, consisted of 10 men (24.39%) and 31 women (75.61%), aged 12-63 years. Based on the status of education, most subjects were graduated from junior/senior high school with 28 subjects (68.29%). The most common cause of BPI was traffic accidents as many as 37 people (90.24%). Mental disorders diagnosed from MINI found ten people (24.39%) were diagnosed with major depression; two subjects (4.87%) had generalized anxiety disorder. The average VAS score was 5.15 and the average DASH score was 52.02. There was no significant difference in VAS scores in the major depression group and PTSD group. However, there was an association between DASH score and depression (p < 0.05). Surprisingly, this study found the risk of suicide among BPI (7.3%) and one person with psychotic disorders (2.43%).

Conclusion: The level of disability and pain in orthopedic trauma patients with depression tend to more severe than without depression.

Keywords: BPI; disability; mental disorders; pain.