ABC of psychological medicine: Trauma

doi:10.1136/bmj.325.7361.426

BMJ 2002;325:426-429 ( 24 August )

Clinical review

ABC of psychological medicine

Trauma

Richard Mayou, Andrew Farmer.

The first 150 words of the full text of this article appear below.

Minor trauma is a part of everyday life, and for most people these injuries are of only transient importance, but some havepsychiatric and social complications. Most people experience majortrauma at some time in their lives.

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Psychological, behavioural, and social factors are all relevant to the subjective intensity of physical symptoms and theirconsequences for work, leisure, and family life. As a result,disability may become greater than might be expected from theseverity of the physical injuries.

Lifetime prevalence of specific traumatic events (n=2181)

Type of trauma Prevalence

Assault 38%

Serious car or motor vehicle crash 28%

Other serious accident or injury 14%

Fire, flood, earthquake, or other natural disaster 17%

Other shocking experience 43%

Diagnosed with a life threatening illness 5%

Learning about traumas to others 62%

Sudden, unexpected death of close friend or relative 60%

Any trauma 90%

Psychological and interpersonal factors also contribute to the cause of trauma, and clinicians should be alert to these andtheir implications for treatment. Tactful questioning, carefulexamination, and detailed record keeping are essential, especiallyfor non-accidental injury by a patient or others:

Ask for a detailed description of the cause of the incident
Ask about previous trauma
Ask about substance misuse $---$ alcohol and drugs
Look for patterns of injuries that may . . . [Full text of this article]

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