{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,17]],"date-time":"2026-08-17T14:07:38Z","timestamp":1786975658538,"version":"build-2736575974"},"reference-count":22,"publisher":"American Medical Association (AMA)","issue":"3","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["JAMA Netw Open"],"abstract":"\n Importance<\/jats:title>\n Evidence suggests that trauma-related mortality and morbidities may follow a multiphasic pattern, with outcomes extending beyond hospital discharge.<\/jats:p>\n <\/jats:sec>\n \n Objectives<\/jats:title>\n To determine the incidence of having new mental health conditions after the first (or index) trauma admission and their association with long-term health outcomes.<\/jats:p>\n <\/jats:sec>\n \n Design, Setting, and Participants<\/jats:title>\n This population-based, linked-data cohort study was conducted between January 1994 and September 2020, with data analyzed in April 2024. Participants were adult patients with trauma admitted to 1 of the 5 adult trauma hospitals in Western Australia. All patients with major trauma with an Injury Severity Score (ISS) greater than 15 were included. For each patient with major trauma, 2 patients with trauma with a lower ISS (&amp;lt;16) were randomly selected.<\/jats:p>\n <\/jats:sec>\n \n Exposure<\/jats:title>\n A new mental health condition recorded in either subsequent public or private hospitalizations after trauma admission.<\/jats:p>\n <\/jats:sec>\n \n Main Outcomes and Measures<\/jats:title>\n The primary outcomes were the associations between new mental health conditions after trauma and subsequent risks of trauma readmission, suicide, and all-cause mortality, as determined by Cox proportional hazards regression. Logistic regression was used to determine which factors were associated with developing a new mental health condition after trauma.<\/jats:p>\n <\/jats:sec>\n \n Results<\/jats:title>\n \n Of 29\u202f191 patients (median [IQR] age, 42 [27-65] years; 19\u202f383 male [66.4%]; median [IQR] ISS, 9 [5-16]; 9405 with ISS &amp;gt;15 and 19\u202f786 with ISS &amp;lt;16) considered, 2233 (7.6%) had a mental health condition before their trauma admissions. The median (IQR) follow-up time after the index trauma admission was 99.8 (61.2-148.5) months. Of 26\u202f958 patients without a prior mental health condition, 3299 (11.3%) developed a mental health condition subsequently, including drug dependence (2391 patients [8.2%], with 419 patients [1.4%] experiencing opioid dependence) and neurotic disorders (1574 patients [5.4%]), including posttraumatic stress disorder. Developing a new mental health condition after trauma was associated with subsequent trauma readmissions (adjusted hazard ratio [aHR], 1.30; 95% CI, 1.23-1.37;\n P<\/jats:italic>\n \u2009&amp;lt;\u2009.001), suicides (aHR, 3.14; 95% CI, 2.00-4.91;\n P<\/jats:italic>\n \u2009&amp;lt;\u2009.001), and all-cause mortality (aHR, 1.24; 95% CI, 1.12-1.38;\n P<\/jats:italic>\n \u2009&amp;lt;\u2009.001). Younger age, unemployment, being single or divorced (vs married), Indigenous ethnicity, and a lower socioeconomic status were all associated with developing a new mental health condition after the first trauma admission.\n <\/jats:p>\n <\/jats:sec>\n \n Conclusions and Relevance<\/jats:title>\n This cohort study of 29\u202f191 patients with trauma found that mental health conditions after trauma were common and associated with an increased risk of adverse long-term outcomes, indicating that mental health follow-up of patients with trauma, particularly those from vulnerable subgroups, may be warranted.<\/jats:p>\n <\/jats:sec>","DOI":"10.1001\/jamanetworkopen.2025.0349","type":"journal-article","created":{"date-parts":[[2025,3,10]],"date-time":"2025-03-10T11:01:16Z","timestamp":1741604476000},"page":"e250349","source":"Crossref","is-referenced-by-count":11,"title":["Long-Term Outcomes and Determinants of New-Onset Mental Health Conditions After Trauma"],"prefix":"10.1001","volume":"8","author":[{"given":"Lai Kin","family":"Yaw","sequence":"first","affiliation":[{"name":"Department of Intensive Care, Fiona Stanley Hospital, Murdoch, Western Australia, Australia"},{"name":"Department of Emergency Medicine, Royal Perth Hospital, Perth, Western Australia, Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Maxine","family":"Burrell","sequence":"additional","affiliation":[{"name":"Retired, State Trauma Unit, Royal Perth Hospital, Perth, Western Australia, Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kwok Ming","family":"Ho","sequence":"additional","affiliation":[{"name":"Department of Anaesthesia and Intensive Care, The Chinese University of Hong Kong, Hong Kong SAR, China"},{"name":"The Prince of Wales Hospital, Hong Kong SAR, China"},{"name":"The Peter Hung Pain Research Institute, the Chinese University of Hong Kong, Hong Kong SAR, China"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"10","published-online":{"date-parts":[[2025,3,10]]},"reference":[{"issue":"18","key":"zoi250031r1","doi-asserted-by":"publisher","first-page":"1723","DOI":"10.1056\/NEJMra1109343","article-title":"Injuries.","volume":"368","author":"Norton","year":"2013","journal-title":"N Engl J Med"},{"issue":"2","key":"zoi250031r2","doi-asserted-by":"publisher","first-page":"187","DOI":"10.1586\/erp.10.8","article-title":"One-year treatment costs of trauma care in the USA.","volume":"10","author":"Weir","year":"2010","journal-title":"Expert Rev Pharmacoecon Outcomes Res"},{"issue":"5","key":"zoi250031r3","doi-asserted-by":"publisher","first-page":"648","DOI":"10.4088\/JCP.14m09661","article-title":"The course of suicide risk following traumatic injury.","volume":"77","author":"Bryant","year":"2016","journal-title":"J Clin Psychiatry"},{"issue":"5","key":"zoi250031r4","doi-asserted-by":"publisher","first-page":"612","DOI":"10.1016\/j.injury.2007.11.426","article-title":"Different definitions of patient outcome: consequences for performance analysis in trauma.","volume":"39","author":"Skaga","year":"2008","journal-title":"Injury"},{"issue":"4","key":"zoi250031r5","doi-asserted-by":"publisher","first-page":"1212","DOI":"10.1097\/TA.0b013e318197b97c","article-title":"Late death after multiple severe trauma: when does it occur and what are the causes?","volume":"66","author":"Probst","year":"2009","journal-title":"J Trauma"},{"issue":"5","key":"zoi250031r6","doi-asserted-by":"publisher","first-page":"788","DOI":"10.1016\/j.jamcollsurg.2009.12.035","article-title":"Moving beyond traditional measurement of mortality after injury: evaluation of risks for late death.","volume":"210","author":"Claridge","year":"2010","journal-title":"J Am Coll Surg"},{"issue":"3","key":"zoi250031r7","doi-asserted-by":"publisher","first-page":"699","DOI":"10.1097\/TA.0b013e318253b5db","article-title":"Chronic consequences of acute injuries: worse survival after discharge.","volume":"73","author":"Shafi","year":"2012","journal-title":"J Trauma Acute Care Surg"},{"issue":"2","key":"zoi250031r8","doi-asserted-by":"publisher","first-page":"210","DOI":"10.1097\/TA.0000000000000930","article-title":"Discovering the truth about life after discharge: long-term trauma-related mortality.","volume":"80","author":"Callcut","year":"2016","journal-title":"J Trauma Acute Care Surg"},{"issue":"10","key":"zoi250031r9","doi-asserted-by":"publisher","first-page":"1001","DOI":"10.1001\/jama.2011.259","article-title":"Long-term survival of adult trauma patients.","volume":"305","author":"Davidson","year":"2011","journal-title":"JAMA"},{"issue":"2","key":"zoi250031r10","doi-asserted-by":"publisher","first-page":"341","DOI":"10.1097\/TA.0b013e3181a5cc34","article-title":"A fate worse than death? long-term outcome of trauma patients admitted to the surgical intensive care unit.","volume":"67","author":"Livingston","year":"2009","journal-title":"J Trauma"},{"issue":"9","key":"zoi250031r11","doi-asserted-by":"publisher","first-page":"1216","DOI":"10.1097\/00005373-199109000-00004","article-title":"Five years\u2019 follow-up of severely injured ICU patients.","volume":"31","author":"Frutiger","year":"1991","journal-title":"J Trauma"},{"issue":"6","key":"zoi250031r12","doi-asserted-by":"publisher","first-page":"580","DOI":"10.1001\/jama.2018.10211","article-title":"Association between traumatic brain injury and risk of suicide.","volume":"320","author":"Madsen","year":"2018","journal-title":"JAMA"},{"issue":"6","key":"zoi250031r13","doi-asserted-by":"publisher","first-page":"e1162","DOI":"10.1097\/SLA.0000000000003780","article-title":"Mental health burden after injury: it\u2019s about more than just posttraumatic stress disorder.","volume":"274","author":"Herrera-Escobar","year":"2021","journal-title":"Ann Surg"},{"issue":"3","key":"zoi250031r14","doi-asserted-by":"publisher","first-page":"312","DOI":"10.1176\/appi.ajp.2009.09050617","article-title":"The psychiatric sequelae of traumatic injury.","volume":"167","author":"Bryant","year":"2010","journal-title":"Am J Psychiatry"},{"issue":"7","key":"zoi250031r15","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pmed.1002322","article-title":"Long-term health status and trajectories of seriously injured patients: a population-based longitudinal study.","volume":"14","author":"Gabbe","year":"2017","journal-title":"PLoS Med"},{"issue":"45","key":"zoi250031r16","doi-asserted-by":"publisher","first-page":"E1319","DOI":"10.1503\/cmaj.180368","article-title":"Mental health outcomes after major trauma in Ontario: a population-based analysis.","volume":"190","author":"Evans","year":"2018","journal-title":"CMAJ"},{"issue":"1","key":"zoi250031r17","doi-asserted-by":"publisher","DOI":"10.1136\/tsaco-2022-001068","article-title":"Measuring long-term outcomes after injury: current issues and future directions.","volume":"8","author":"Salim","year":"2023","journal-title":"Trauma Surg Acute Care Open"},{"issue":"2","key":"zoi250031r19","doi-asserted-by":"publisher","first-page":"519","DOI":"10.1016\/j.injury.2022.11.002","article-title":"Trauma recidivism is pervasive and is associated with mental and social health opportunities.","volume":"54","author":"Heimke","year":"2023","journal-title":"Injury"},{"issue":"11","key":"zoi250031r20","doi-asserted-by":"publisher","first-page":"95","DOI":"10.1007\/s11920-018-0969-9","article-title":"Social determinants of mental health: where we are and where we need to go.","volume":"20","author":"Alegr\u00eda","year":"2018","journal-title":"Curr Psychiatry Rep"},{"issue":"7","key":"zoi250031r21","doi-asserted-by":"publisher","first-page":"1945","DOI":"10.1177\/00031348241241677","article-title":"Interpersonal violence and social determinants of health.","volume":"90","author":"Sawyers","year":"2024","journal-title":"Am Surg"},{"issue":"5","key":"zoi250031r22","doi-asserted-by":"publisher","first-page":"266","DOI":"10.1097\/JTN.0000000000000388","article-title":"The social determinants of trauma: a trauma disparities scoping review and framework.","volume":"25","author":"Mikhail","year":"2018","journal-title":"J Trauma Nurs"},{"key":"zoi250031r18","unstructured":"Australian Bureau of Statistics. Socio-economic indexes for areas (SEIFA), Australia methodology. 2021. Accessed January 29, 2025. https:\/\/www.abs.gov.au\/methodologies\/socio-economic-indexes-areas-seifa-australia-methodology\/2021"}],"container-title":["JAMA Network Open"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/jamanetwork.com\/journals\/jamanetworkopen\/articlepdf\/2831185\/yaw_2025_oi_250031_1740757247.34218.pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,3,10]],"date-time":"2025-03-10T11:01:19Z","timestamp":1741604479000},"score":1,"resource":{"primary":{"URL":"https:\/\/jamanetwork.com\/journals\/jamanetworkopen\/fullarticle\/2831185"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,3,10]]},"references-count":22,"journal-issue":{"issue":"3","published-print":{"date-parts":[[2025,3,3]]}},"URL":"https:\/\/doi.org\/10.1001\/jamanetworkopen.2025.0349","relation":{},"ISSN":["2574-3805"],"issn-type":[{"value":"2574-3805","type":"electronic"}],"subject":[],"published":{"date-parts":[[2025,3,10]]}}}