Anxiety, depression and substance abuse among orthopaedic trauma patients

Introduction: Rates of anxiety and depression have been found to be high among individuals who have sustained orthopedic trauma, and anxiety or depression is associated with higher rates of alcohol and tobacco use. Managing mental health issues within the orthopedic trauma population, therefore, requires concomitant consideration of patient-level substance use and abuse. Methods: A cross sectional survey was conducted at two New South Wales level one trauma facilities of orthopedic trauma patients. Across a 15-monthstudy period, eligible patients were approached while in hospital and invited to participate in an online health behavior survey. Results: Data collection will be finalized by July 2016. Interim results from the first 641 surveys found 21% of patients identified as current daily or occasional tobacco users, 29% were ex-smokers and 49% non-smokers. AUDIT-C measures indicated that 26% of patients identified as non drinkers, 60.5% self-identified as non-heavy drinkers and 13% identified as heavy drinkers. Concurrent tobacco and heavy drink was found in 11%of current tobacco users. 17% of current tobacco users versus 9% of nonusers reported having moderate to severe anxiety as measured by the GAD7. Of the current tobacco users, 17% were above threshold for depression while 12% of non-users were above threshold for depression when measured using the PHQ-2.Conclusions: It is important to understand the associations between anxiety or depression and substance use amongst hospitalized patients so that interventions aimed at targeting these behaviors can be developed.