Factors associated with anxiety and depression following acute hand trauma: a prospective study of 134 patients

INTRODUCTION: Acute hand trauma is frequently accompanied by psychological distress; however, the demographic and injury-related factors associated with this response remain poorly understood. This study aimed to identify factors associated with early psychological distress in patients with acute hand trauma. METHODS: We prospectively evaluated 134 adult patients presenting with acute hand trauma. Patients completed the Beck Anxiety Inventory (BAI) and Beck Depression Inventory (BDI), and psychiatric symptoms were additionally assessed by a psychiatrist using the Brief Psychiatric Rating Scale (BPRS). Demographic characteristics, psychiatric history, pain scores, injury characteristics, and structural injuries were recorded. Multivariable linear regression analysis was performed to identify independent factors associated with psychological distress. RESULTS: Anxiety symptoms were the most common psychological manifestation, affecting 44% of patients. Previous psychiatric history, nerve injury, and work-related injury were independently associated with higher psychological distress scores. Younger age and female sex showed associations in univariable analyses but were not independent predictors after multivariable adjustment. CONCLUSION: Early psychological distress following acute hand trauma appears to be influenced primarily by patient-related factors and nerve injury rather than anatomical injury level alone. Early psychological screening should be considered, particularly for patients with a previous psychiatric history or concomitant nerve injury.