Rates and temporal onset of mental health disorders during inpatient rehabilitation after acute physical injury or illness: An observational cohort study

Abstract

Purpose Patients exposed to acute injury or illness are at increased risk of developing mental health disorders, and at the same time, mental health disorders increase the risk for injury and illness. This study aimed to determine the rate and onset of mental health disorders in a mixed patient group receiving inpatient specialized rehabilitation following acute physical injury or illness and to assess whether mental health disorders emerged before or after the injury or illness. Methods Patients were recruited over a one-year period (2020–2021) during inpatient rehabilitation. To follow the patients` lifetime history of psychiatric morbidity, mental health disorders, including substance use disorders, were assessed using the M.I.N.I Plus structured diagnostic interview over two periods: 1) retrospective report of mental health disorders before injury or illness and 2) mental health disorders present during rehabilitation. In the latter case, we also took into account whether the condition was present at the time of injury or illness. Demographic and injury data were retrieved from medical charts, patient interviews, and the Oslo University Hospital Trauma Registry. Results The study included 130 patients, of whom 49% had a lifetime history, and 38% met the diagnostic criteria for one or more mental health disorders during inpatient rehabilitation. Specifically, the vast majority (72%) of patients with a current disorder had the condition already at the time of injury or illness. Only 5% developed a mental health disorder after injury or illness without having a lifetime history. Conclusion Mental health disorders are common and often predate patients physical injury or illness. Assessing patients` mental health in the sub-acute phase, without considering their mental health history, and especially their mental state at the time of injury or illness, may lead to an overestimation of injury or illness’s impact on mental health.