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PSYCHIATRIC DISTURBANCE AND ACUTE STRESS RESPONSES IN SURGICAL PATIENTS
Author(s) -
Clarke David M.,
Russell Prudence A.,
Polglase Adrian L.,
McKenzie Dean P.
Publication year - 1997
Publication title -
australian and new zealand journal of surgery
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.111
H-Index - 51
eISSN - 1445-2197
pISSN - 0004-8682
DOI - 10.1111/j.1445-2197.1997.tb01914.x
Subject(s) - medicine , anxiety , coping (psychology) , depression (economics) , psychological intervention , psychiatry , acute stress disorder , clinical psychology , economics , macroeconomics
Background : A number of reports have appeared of post‐traumatic stress symptoms occurring in physically ill patients. This study sought to measure the extent of psychiatric disturbance and acute post‐traumatic stress reactions occurring in surgical inpatients, and to examine their relationship with the stress of illness and hospitalization and the personal coping style of the patient. Methods : Thirty‐seven admissions to a general surgical unit were assessed on admission and immediately prior to discharge. Measures were made of depression, anxiety, cognitive impairment, post‐traumatic stress symptoms, severity of illness, level of physical functioning, degree of hospital stress and coping style. Results : There was a significant reduction in anxiety scores postoperatively. Twenty‐seven per cent of patients developed high levels of acute post‐traumatic stress symptoms and these correlated with depression at admission and intra‐hospital stress. Depression at discharge was related to depression at admission, physical functioning and coping style. In general, avoidance and acceptance‐resignation were associated with a poorer psychiatric outcome. Conclusions : Postoperative psychiatric disturbance, including acute stress symptoms, can be understood as a reaction to the ‘trauma’ of illness and hospitalization, predisposed to by pre‐existing depression. Interventions could be directed at screening for at‐risk patients, minimizing stress, and encouraging adaptive mechanisms of coping in patients.