Qatar study points to need for screening of post-traumatic stress disorder

A recent study by a group of Qatar-based researchers has highlighted the need for screening of post-traumatic stress disorder (PTSD) and depression for improving the patient's quality of life after an injury.The study titled ‘Early referral of trauma patients to dedicated trauma psychology service: An observational study screening for post-traumatic stress disorder and depression’ involved 1,245 patients who were admitted to the trauma service between September 2019 and December 2020. This study has revealed very interesting facts and how screening for PTSD can enhance patients once they have come out of the trauma stage. It used a retrospective case study design, which collected, analysed, and descriptively reported data related to trauma patients admitted to the Trauma Surgery Unit for 16 months. The data of all patients that met the inclusion criteria were included in this study, which used a non-probability purposive sampling method.The research work published recently on Qscience.com assessed the utility of PTSD and depression screening and the early referral to the trauma psychology service at a level 1 trauma centre. The Injured Trauma Survivor Screen (ITSS) and an additional criteria checklist were used for patient screening, and data were analysed. The screening was conducted within 24 hours of the admission of trauma patients.The findings of the study showed that the integration of the new screening tool into a standard of care requires a significant amount of time. Screening compliance increased from 84% to 100% throughout the duration of the study. Notably, there was a 10% gap in the referral of patients identified through the ITSS tool, with 64% referrals based on the symptom checklist.During the study period, a total of 1,352 consecutive patients admitted to the Trauma Surgery Unit were assessed for eligibility, resulting in 1,245 patients who met the data collection criteria being enroled in the analysis. The median age of the patients was 34 years with 90.7% being male.The study found that patients aged between 30 and 40 years (52%) had a higher risk for developing both PTSD and depression. Overall, the referrals made to the trauma psychology service, based on the ITSS tool and the additional criteria, accounted for 79% of cases. The highest number of referred patients (91) reported experiencing intolerable pain, which was assessed as a standard of care using the numerical rating scale. Among these patients, 95% were referred for psychological support.According to the researchers, "The team hypothesised that as the screening process becomes more established as a standard of care, compliance with screening would improve. Furthermore, early referral of trauma patients to a dedicated psychologist within the trauma care system would be beneficial.”The study has noted psychological challenges, such as depression and post-traumatic distress, are common outcomes following traumatic injuries and the psychological factors significantly influence the recovery process of individuals. Therefore, it is crucial to diagnose, refer, and treat these disorders as part of the care provided to trauma patients. Patients who are predisposed to developing mental health challenges and show subthreshold symptoms often develop into major depressive episodes, highlighting the importance of addressing these concerns.The article concluded that current screening methods used as a standard of care show good utility value in identifying trauma patients predisposed to developing PTSD or depression, warranting their continued use. Facilitating direct referrals to the trauma psychology service by attending staff, including nurses, could help bridge the gap in patient identification and referral.