Kuan-Han Lin

Psychological Outcome of Injured Workers at 3 Months after Occupational Injury Requiring Hospitalization in Taiwan

Psychological Outcome of Injured Workers at 3 Months after Occupational Injury Requiring Hospitalization in Taiwan: Kuan‐Han LIN, et al. Institute of Occupational Medicine and Industrial Hygiene, National Taiwan University School of Public Health, Taiwan—Introduction: After a traumatic event, a significant proportion of victims develop psychiatric disorders. Trauma has been an important ailment among workers. This study aimed to determine the prevalence of post‐traumatic stress disorder (PTSD) and other psychiatric disorders at three months after occupational injuries.

Psychiatric disorders after occupational injury among National Health Insurance enrollees in Taiwan.

This study aimed to determine the incidence rates of psychiatric disorders within 1 year after occupational injury and to examine the association between occupational injury and the incidence of psychiatric disorders using National Health Insurance Research Database (NHIRD). We used cohort approach in this investigation. All eligible subjects were from the NHIRD, and aged 18-65 years old. A total of 542,208 patients were enrolled in this study. Among them, 1038 patients sustained occupational injury, 6891 patients sustained non-occupational injury. The reference group in this study was 534,279 patients who ever used the NHI for any medical condition in 2001. The incidence rates of any psychiatric disorders within 1 year after occupational injury (inpatient), occupational injury (outpatient), non-occupational injury (inpatient), non-occupational injury (outpatient), and any disease were 9.5%, 2.5%, 7.4%, 1.5%, and 1.1%, respectively. Occupational injury was found as a significant factor for developing psychiatric disorders within 1 year after the target injury. The incidence rate of any psychiatric disorders was higher in patients after occupational injury than those after non-occupational injury and any medical condition.

Suicidality 6 Years After Occupational Injury

OBJECTIVE Suicide attempts can result from traumatic events, including those caused by occupational injury. However, literature on the long-term prevalence rates of suicidality after occupational injury is relatively lacking. This study investigated the long-term prevalence of suicidality after occupational injury. METHODS Between February 1 and August 31, 2009, 4,403 workers in Taiwan sustained occupational injuries and were hospitalized for 3 days or longer. Surveys were conducted at 3 and 12 months after occupational injury, and 2,308 workers responded to either survey. They were invited to join the follow-up at 6 years after occupational injury, using the Brief Symptom Rating Scale (BSRS-5), Posttraumatic Symptom Checklist (PTSC), and 1 question on suicidal ideation. Workers with a high score on the BSRS-5 or PTSC were invited to participate in an in-depth psychiatric evaluation using the Chinese version of the Mini-International Neuropsychiatric Interview (MINI). RESULTS The estimated MINI-diagnosed suicidality rates at 3 months, 12 months, and 6 years after occupational injury were 5.4%, 4.8%, and 9.5%, respectively. Injured workers who reported that the injury majorly affected their physical appearance, experienced additional occupational injury requiring hospitalization for > 3 days, had unstable employment, and had lower income in the past 1 year than that before occupational injury had a higher risk of suicidal ideation. Injury majorly affecting the physical appearance, unstable employment, and lower income than that before occupational injury were the most crucial factors. These factors accounted for 12.7%, 13.2%, and 19.0% of suicidal ideation among the injured workers. CONCLUSIONS The suicidality rate increased at 6 years after occupational injury. The relevant factors for suicidal ideation were injury severity and work instability. Periodic monitoring of psychological and physical health and economic stability are warranted.

0089 Recovery from mental condition: is it different between TBI/non-TBI

Objectives This study aimed to determine the rates of psychological symptoms among those with traumatic brain injury (TBI) and with non-TBI at 3 months and 12 months after occupational injury and to examine the change in psychological status over time. Method Our study candidates were injured workers in Taiwan who were hospitalised for 3 days or longer and received hospitalisation benefits from the Labour Insurance. A self-reported questionnaire including Brief Symptom Rating Scale (BSRS-50) and Post-traumatic Symptom Checklist (PTSC) was sent to workers at 3 months and 12 months. Results Among 853 injured workers who completed the questionnaire at 3 and 12 months, regarding to the severity of BSRS score, 7.8% of those with TBI had recovered at 12 months, comparing with 8.1% in those with non-TBI. On the other hand, approximately11.6% of those with TBI had recovered from post-traumatic stress symptoms at 12 months, comparing with 9.7% among those with non-TBI. Injured workers with TBI had lower rate of recovery from psychological symptoms, comparing with non-TBI. Conclusions A significant proportion of victims with TBI and non-TBI suffered psychological symptoms after injury. The identification and treatment of psychological symptoms are important for optimal adaptation after traumatic injury.

0193 PREDICTION OF MENTAL OUTCOMES BY EARLY CONDITIONS AFTER OCCUPATIONAL INJURIES

Objectives Psychiatric diseases have been an important complication after occupational injuries. This study aimed to determine early factors predicting psychological health outcomes at twelve months after occupational injuries. Method The study candidates were workers who sustained occupational injuries and were hospitalised for 3 days or longer in 2009. A self-reported questionnaire was sent to them at three months after injury. The questionnaire inquired about demographics, severity of injury, working status, personal factors, as well as included a psychometric instrument Brief Symptom Rating Scale (BSRS-50). At one year, all participants were invited again to complete a questionnaire including BSRS-50. Results A total of 853 workers completed the questionnaire at three months and 12 months after injury. Among them, 84 (9.3%) had general severity index (GSI) of 70 or higher at 12 months after injury, indicating poor psychological condition. Using multivariate logistic regression analysis for mutual adjustment, predictive factors for elevated GSI were found to include dismemberment or affected physical appearance (OR 1.7, 95% CI 1.0–3.1), BSRS at 3 months after injury (OR 8.8, 95% CI 5.4–14.4), and having to leave original workplace (OR 2.5, 95% CI 1.4–4.3). The findings indicated that severity of injury, early psychological condition, and workplace accommodation to allow returning to original workplace are important factors for later psychological health after occupational injury. Conclusions Among workers sustaining occupational injuries, psychological condition could have been affected at 12 months after injury. Predictors of the psychological condition were identified, to allow for possibility of early intervention.