Preinjury psychopathology in trauma patients

One hundred patients admitted to a Level I trauma center were interviewed using the Langner 22-item index of psychiatric symptoms to evaluate pre-existing psychological pathology. The medical chart was also examined for any type of note or evidence of psychiatric consultation efforts by the surgical attending staff. There were 74 males and 26 females in the sample, with a mean age of 33 years. Types of injuries included blunt trauma in 71% and penetrating trauma in 29% of the group, respectively. Eight per cent of these injuries were self inflicted. The mean Injury Severity Score was 17. Alcoholic intoxication was documented in 49%. We found that severe psychopathology as defined by the Langner Index was present in 88% of those admitted with penetrating trauma, in 47% of those admitted with blunt trauma, and in 75% of the intoxicated group. In only 14% of the sample was psychopathology documented in the chart by the attending staff. Preinjury psychopathology in trauma patients was commonly present and seemed to be most highly associated with penetrating trauma and alcohol use.