A Comparative Study of Post-traumatic Stress Disorder, Anxiety, Depression and Change in Sexual Functioning of Patients with Facial Injuries and Patients with Extremity Injuries

Abstract

Background: This study was performed to identify and compare the presence of and the levels of post-traumatic stress disorder (PTSD), anxiety, depression and if any change in sexual functioning is present in patients with disfiguring facial injuries, nondisfiguring facial injuries and visible extremity injuries. Materials and methods: A total of 378 patients from multi modal trauma centers in Bengaluru city were included for the study. A total of 153 patients were those who had disfiguring facial injuries, 111 patients with nondisfiguring facial injuries and 114 patients had sustained a visible extremity injury that was not covered by clothing (disfigurement /scarring). The assessments were carried out at three time intervals (the date of discharge, 1 month postoperatively and 6 months postoperatively) of the follow-up. The impact of events scale (IES), the hospital anxiety and depression scale (HADS) and changes in sexual functioning questionnaire (CSFQ) were used. Results: Statistically significant higher means of IES, HADS (both for anxiety and depression) were present in patients with disfiguring facial injuries compared to patients with nondisfiguring facial injuries and visible extremity injuries and this was present at all three study intervals (date of discharge,1st postoperative month and 6th postoperative month). There was a statistically significant change in the means of CSFQ scores of visible extremity injuries compared to other groups at the date of discharge bordering on sexual dysfunction, there was a raise in CSFQ scores among all three groups at the 1st postoperative month and the 6th postoperative month which was above the dysfunction cut-off. Conclusion: The results of this study led to the conclusion that in comparison with patients who had sustained disfiguring facial injuries, nondisfiguring facial injuries and visible extremity/ orthopedic injuries, the mean IES scores, HADS scores for both anxiety and depression of the facial disfiguring injury patients was higher at all three study intervals (date of discharge,1st postoperative month and 6 months postoperatively), indicating higher PTSD levels, anxiety and depression in patients with disfiguring facial injuries, CSFQ scores were above the cutoff suggested at the 1st month and 6th month postoperative indicating no sexual dysfunction in all the three groups.