Three distinct patterns of mental health response following accidents in mountain sports: a follow-up study of individuals treated at a tertiary trauma center.

Autor: Salvotti HV; Department of Psychiatry, Psychotherapy, Psychosomatics and Medical Psychology, University Hospital for Psychiatry II, Medical University of Innsbruck, Innsbruck, Austria.; Department of Neurosurgery, University Hospital of Regensburg, Regensburg, Germany., Tymoszuk P; Data Analysis as a Service Tirol, Wörgl, Austria., Ströhle M; Department of Anesthesiology and Critical Care Medicine, Bezirkskrankenhaus Kufstein, Kufstein, Austria.; Austrian Society of Mountain and High-Altitude Medicine, Mieming, Austria., Paal P; Austrian Society of Mountain and High-Altitude Medicine, Mieming, Austria.; Department of Anesthesiology and Critial Care Medicine, Paracelsus Medical University, Salzburg, Austria.; Austrian Board of Mountain Safety (Österreichisches Kuratorium fur Alpine Sicherheit), Innsbruck, Austria.; International Commission for Mountain Emergency Medicine (ICAR MedCom), Kloten, Switzerland., Brugger H; International Commission for Mountain Emergency Medicine (ICAR MedCom), Kloten, Switzerland.; Institute of Mountain Emergency Medicine, Eurac Research, Bolzano/Bozen, Italy.; International Society of Mountain Medicine (ISMM), Montreal, Canada., Faulhaber M; Austrian Society of Mountain and High-Altitude Medicine, Mieming, Austria.; Department of Sport Science, University of Innsbruck, Innsbruck, Austria., Kugler N; Department of Orthopedics and Traumatology, Medical University of Innsbruck, Innsbruck, Austria., Beck T; Medical Directorate, Innsbruck Regional Hospital, Innsbruck, Austria., Sperner-Unterweger B; Department of Psychiatry, Psychotherapy, Psychosomatics and Medical Psychology, University Hospital for Psychiatry II, Medical University of Innsbruck, Innsbruck, Austria., Hüfner K; Department of Psychiatry, Psychotherapy, Psychosomatics and Medical Psychology, University Hospital for Psychiatry II, Medical University of Innsbruck, Innsbruck, Austria. katharina.huefner@tirol-kliniken.at.; Austrian Society of Mountain and High-Altitude Medicine, Mieming, Austria. katharina.huefner@tirol-kliniken.at.
Jazyk: angličtina
Zdroj: European archives of psychiatry and clinical neuroscience [Eur Arch Psychiatry Clin Neurosci] 2024 Sep; Vol. 274 (6), pp. 1289-1310. Date of Electronic Publication: 2024 May 10.
DOI: 10.1007/s00406-024-01807-x
Abstrakt: The restorative effect of physical activity in alpine environments on mental and physical health is well recognized. However, a risk of accidents and post-accident mental health problems is inherent to every sport. We aimed to characterize mental health in individuals following mountain sport accidents requiring professional medical management. Adult victims of mountain sport accidents treated at the hospital of the Medical University of Innsbruck (Austria) between 2018 and 2020 completed a cross-sectional survey at least 6 months following the admission (median 44 months, n = 307). Symptoms of post-traumatic stress disorder (PTSD, PCL-5), anxiety, depression, and somatization (PHQ), resilience (RS-13), sense of coherence (SOC-9L), post-traumatic growth (PTGI), and quality of life (EUROHIS-QOL), as well as sociodemographic and clinical information, were obtained from an online survey and extracted from electronic health records. Mental health outcome patterns were investigated by semi-supervised medoid clustering and modeled by machine learning. Symptoms of PTSD were observed in 19% of participants. Three comparably sized subsets of participants were identified: a (1) neutral, (2) post-traumatic growth, and (3) post-traumatic stress cluster. The post-traumatic stress cluster was characterized by high prevalence of symptoms of mental disorders, low resilience, low sense of coherence, and low quality of life as well as by younger age, the highest frequency of pre-existing mental disorders, and persisting physical health consequences of the accident. Individuals in this cluster self-reported a need for psychological or psychiatric support following the accident and more cautious behavior during mountain sports since the accident. Reliability of machine learning-based prediction of the cluster assignment based on 40 variables available during acute medical treatment of accident victims was limited. A subset of individuals show symptoms of mental health disorders including symptoms of PTSD when assessed at least 6 months after mountain sport accident. Since early identification of these vulnerable patients remains challenging, psychoeducational measures for all patients and low-threshold access to mental health support are key for a successful interdisciplinary management of victims of mountain sport accidents.
(© 2024. The Author(s).)
Databáze: MEDLINE
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