Of 200 consecutively admitted leg fracture patients, 101 consented to be screened for psychopathology using the BSI and SMAST questionnaires. Probable cases of psychopathology were referred for diagnostic psychiatric evaluation. Of the participants, 80.2 percent were identified as possible psychiatric cases. Diagnostic evaluation revealed high prevalence of substance abuse (66.0%), depression (46.8%), and personality pathology (38.3%). Accident victims tended to be single young males. Accidents occurred mostly during leisure hours, and were often associated with alcohol use. Psychiatric assistance appears essential in the management of such patients. Psychiatrists need to be especially knowledgeable about chemical dependency, interpersonal issues and psychotherapy.
Get full access to this article
View all access options for this article.
References
1.
ShevitzS. A.SilberfarbP. M., and LipowskiZ. J., Psychiatric Consultations in a General Hospital. A Report on 1,000 Referrals, Diseases of the Nervous System, 27, pp. 295–299, 1979.
2.
LipowskiZ. J. and WolstonE. J., Liaison Psychiatry. Referral Patterns and Their Stability over Time, American Journal of Psychiatry, 138, pp. 1608–1611, 1981.
3.
SchwabJ. J., Psychiatric Illness in Medical Patients: Why It Goes Undiagnosed, Psychosomatics, 23, pp. 225–229, 1982.
4.
McKegneyF. F. and BeckhardtR. M., Evaluative Research in Consultation-Liaison Psychiatry. Review of the Literature 1970–1981, General Hospital Psychiatry, 4, pp. 197–218, 1982.
5.
CavanaughS. and WettsteinR. M., Prevalence of Psychiatric Morbidity in Medical Populations, in Psychiatry Update—The American Psychiatric Association Annual Review, Volume III, GreenspoonL. (ed.), American Psychiatric Press, Inc., Washington, D.C., pp. 187–214, 1984.
6.
GobarA. H.CollirisJ. L., and MathuraC. B., Utilization of a Consultation Liaison Psychiatry Service in a General Hospital, Journal of the National Medical Association, 79, pp. 505–508, 1987.
7.
McKegneyF. P.McMahonT., and KingJ., The Use of DSM-III in a General Hospital Consultation-Liaison Service, General Hospital Psychiatry, 5, pp. 115–121, 1983.
8.
KuhnW. F.BellR. A.FriersonR. L., and LippmannS. B., Consultative Psychiatry in Both Private and Public General Hospitals, General Hospital Psychiatry, 8, pp. 236–240, 1986.
9.
KuhnW. F. and LacefieldP. K., Patient, Surgeon, Nurse: The Psychological Impact of Fracture Treatment, in Concepts in Intramedullary Nailing, SeligsonD. (ed.), Grune & Stratton, Orlando, pp. 187–197, 1985.
10.
RosenbaumJ. F., The Accident Victim, in The Massachusetts General Hospital Handbook of General Hospital Psychiatry, HackettT. P. and CassemN. H. (eds.), C. V. Mosby, St. Louis, 1978.
11.
WeismanA. D., Coping with Illness, in The Massachusetts General Hospital Handbook of General Hospital Psychiatry, HackettT. P. and CassemN. H. (eds.), C. V. Mosby, St. Louis, 1978.
12.
KuhnW. F.BellR. A.SeligsonD.LauferS. T., and LindnerJ. E., The Tip of the Iceberg: Psychiatric Consultations on an Orthopedic Service, International Journal of Psychiatry in Medicine, 18, pp. 383–389, 1988.
13.
ImbodenJ. B. and UrbaitisJ. C., Psychological Reactions during Hospitalization: Their Evaluation and Management, in Practical Psychiatry in Medicine, Appleton-Century-Crofts, New York, pp. 40–59, 1978.
14.
HackettT. P. and WeismanA. D., Psychiatric Management of Operative Syndromes II, Psychosomatic Medicine, 22, pp. 356–372, 1960.
15.
SelzerM., Alcoholism and Alcoholic Psychosis, in Comprehensive Textbook of Psychiatry-III, Volume 2, KaplanH. I.FreedmanA. M., and SadockB. J. (eds.), William and Wilkins, Baltimore, pp. 1629–1644, 1980.
16.
BeresfordT.LowD.AdducisR., and GoggansF., Alcoholism Assessment on an Orthopedic Surgery Service, Journal of Bone and Joint Surgery, 64-A, pp. 730–733, 1982.
17.
BoernerM.Winter-KlemmB., and KlemmK., Der gefallene Ikarus oder der schwerverletzte jugendliche Motorradfahrer, Unfallchirurgie, 8, pp. 1–7, 1982.
18.
KahanaR. J. and BibringG. L., Personality Types in Medical Management, in Psychiatry and Medical Diagnosis in a General Hospital., ZinbergN. (ed.), International Universities Press, New York, pp. 108–123, 1964.
19.
PutnamN. and YagerJ., Traction Intolerance Syndrome: A Psychiatric Complication of Femoral Fractures, International Journal of Psychiatry in Medicine, 8, pp. 133–143, 1977–1978.
20.
DerogatisL. R. and MelisaratosN., The Brief Symptom Inventory: An Introductory Report, Psychological Medicine, 13, pp. 595–605, 1983.
21.
DerogatisL. R. and SpencerP. M., The Brief Symptom Inventory (BSI): Administration, Scoring and Procedure Manual-I, Clinical Psychometric Research, Baltimore, 1975.
22.
SelzerM. L.VinokurA., and van RooijenJ., A Self-administered Short Michigan Alcoholism Screening Test (SMAST), Journal of Studies on Alcohol, 36, pp. 117–126, 1975.
23.
American Psychiatric Association, Diagnostic and Statistical Manual, Third Edition (DSM-III), American Psychiatric Association Publications, Washington, D.C., 1980.
24.
BellR. A.WarheitG. J.BellR. A., and SandersG., An Analytic Comparison of Persons Arrested for Driving While Intoxicated and Alcohol Detoxification Patients, Alcoholism: Clinical and Experimental Research, 2, pp. 241–247, 1978.
25.
HerveC.GaillardM.RoujasF., and HuguenardP., Alcoholism in Polytrauma, Journal of Trauma, 26, pp. 1123–1126, 1986.
26.
TsuangM. T.BoorM., and FlemingJ. A., Psychiatric Aspects of Traffic Accidents, American Journal of Psychiatry, 142, pp. 538–546, 1985.
27.
DulitR. A.StrainJ. J., and StrainJ. J., The Problem of Alcohol in the Medical-Surgical Patient, General Hospital Psychiatry, 8, pp. 81–85, 1986.
28.
MitchellW. D.ThompsonT. L., and CraigS. R., Underconsultation and Lack of Follow-up for Alcohol Abusers in a University Hospital, Psychosomatics, 27, pp. 431–437, 1986.
29.
CohenM.KernJ. C., and HassetC., Identifying Alcoholism in Medical Patients, Hospital and Community Psychiatry, 37, pp. 398–400, 1986.
30.
AlexopoulosG. S.BresciaR. A.FrancesR. J., and SeixasF. A., Managing Alcoholic Medical Patients: The Psychiatrist's Role, Psychosomatics, 22, pp. 598–605, 1981.
31.
ElvyG. A. and GillespieW. J., Problem Drinking in Orthopaedic Patients, Journal of Bone and Joint Surgery, 67-B, pp. 478–481, 1985.
