OBJECTIVE To describe the prevalence and prognostic factors of symptoms of anxiety and depression and posttraumatic stress symptoms (PTSS) after injury in the clinical trauma population. DESIGN Multicentre prospective observational cohort study. SETTING Ten hospitals in Noord-Brabant, the Netherlands. PARTICIPANTS 4,239 adult trauma patients admitted between August 2015 and December 2016 INTERVENTIONS: Patients were asked to complete a questionnaire at one week, and one, three, six and twelve months after injury. MAIN OUTCOME MEASURES The Hospital Anxiety and Depression Scale was used to assess anxiety and depressive symptoms and the Impact of Event Scale was used to assess PTSS. RESULTS The prevalence of symptoms of anxiety and depression decreased from 10% and 12% respectively at one week after injury to 7% and 7% at twelve months after injury. Acute traumatic stress symptoms were present in 13% at one week and PTSS was prevalent in 10% of the participants at twelve months after injury. Strong prognostic factors for poor psychological outcome in multivariable logistic mixed models were pre-injury frailty, psychological complaints and non-working status pre-injury, female gender, low educational level and accident category (i.e. traffic accident, work-related or accidents at home compared to sport injuries). CONCLUSION Psychological distress is a common health problem during the first year after injury. Important prognostic factors for psychological distress include psychological complaints before injury and frailty. Early recognition of psychological problems after injury could facilitate discussion between caregivers and patients and improve recovery.

中文翻译：

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创伤后心理困扰的患病率和预后因素

目的 描述临床创伤人群创伤后焦虑抑郁症状和创伤后应激症状（PTSS）的患病率和预后因素。设计 多中心前瞻性观察队列研究。地点 荷兰北布拉班特省的十家医院。参与者 2015 年 8 月至 2016 年 12 月期间入院的 4,239 名成人创伤患者 干预：要求患者在受伤后一周、1、3、6 和 12 个月完成问卷。主要观察指标 医院焦虑和抑郁量表用于评估焦虑和抑郁症状，事件影响量表用于评估 PTSS。结果 焦虑和抑郁症状的患病率分别从伤后 1 周时的 10% 和 12% 下降到伤后 12 个月时的 7% 和 7%。13% 的参与者在一周内出现急性创伤应激症状，10% 的参与者在受伤后 12 个月内普遍存在 PTSS。多变量逻辑混合模型中不良心理结果的强预后因素是伤前虚弱、心理主诉和伤前非工作状态、女性、低教育水平和事故类别（即交通事故、与工作有关或在家中发生的事故）与运动损伤相比）。结论 心理困扰是受伤后第一年内常见的健康问题。心理困扰的重要预后因素包括受伤和虚弱前的心理抱怨。尽早识别受伤后的心理问题可以促进护理人员与患者之间的讨论并促进康复。