Evaluation Of Depression Associated With Post -Traumatic Stress Disorder After Maxillofacial Injuries – A Prospective Study

Publication date: Available online 21 February 2018
Source:Journal of Oral and Maxillofacial Surgery
Author(s): Vatsala Ranganathan, Elavenil Panneerselvam, Saravanan Chellappazham, Sasikala Balasubramaniam, Krishnakumar Raja V B
IntroductionMaxillofacial injuries may result in psychological derangement of an individual, leading to post-traumatic stress disorder (PTSD) which is characterized by continual re-experiencing of any traumatic event along with numerous systemic complications.ObjectivesTo assess the incidence & severity of "PTSD related depression" in patients with maxillofacial injuries and to identify the risk factors involved.Methodology: The prospective study involved 88 patients with maxillofacial trauma who were grouped into (A) - Patients with cosmetic deficit alone, (B)- Patients with functional deficit alone and (C)- Patients with both cosmetic and functional deficit.The psychological status of all patients was assessed before & after surgery, using the Zung's Self rating Depression Scale. The remission time was also analysed.Statistical analysisData was analysed with SPSS, using parametric methods. Comparison of mean values between groups was done using one way ANOVA followed by Tukey's HSD post hoc tests for multiple pairwise comparisons. To compare proportions, Chi-Square test was applied.ResultsThe number of patients in Group A, B & C was 11, 34 and 43, respectively. In the immediate post- trauma stage, all patients in group A showed severe depression, while the percentage of patients with severe depression in group B and C were 8.8 and 81.4%, respectively, which was statistically significant. The depression scores in patients of all groups decreased gradually in the post- surgical phase. Patients with cosmetic defects consistently show relatively higher depression scores, at all time- intervals. The time taken for recovery from depression (Remission time) was lesser in patients with functional deficit alone (Group B).ConclusionPatients with maxillofacial injuries are prone to "PTSD related depression" due to both functional and cosmetic deficits. The objectives of trauma management must be aimed at restoring pre-trauma form & function of maxillofacial skeleton as well as patient's psychological status.



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