Mental Findings in Trauma Victims.

Introduction: In medico-legal evaluation of trauma patients, the bio-psychological effects of the trauma and the severity of the injuries require to be evaluated. In this study, assuming the fact that psychiatric assessment are not taken into consideration in physical trauma cases, we have planned to bring up the presence of psychological trauma in our medico-legally evaluated patients due to different types of traumas and review the mental findings and diagnoses in trauma victims. Methods: We retrospectively analyzed the hospital records of 1975 patients aged 18 years or older who presented to the Department of Forensic Medicine at Dokuz Eylul University School of Medicine for medico-legal evaluation between 1999 and 2009. Psychiatric assessment was performed in 142 patients by Consultation and Liaison Psychiatry Section of the university hospital. Data contained in medico-legal reports and patient records were then examined with respect to patients' age, gender, nature of traumatic events, psychiatric diagnoses, descriptive characteristics of patients, severity of trauma, and past history of mental disorder and trauma experience. Results of the medico-legal evaluations were also analyzed. Results: Of the 142 patients, 80 (56.3%) were female and their average age was 40.30 +/- 17.17 years. The most frequent traumatic events were traffic accidents (29.6%) and violence-related blunt force trauma (28.9%). The distribution of foremost psychiatric diagnoses were anxiety disorders in 69 cases (48.6%), adjustment disorders in 16 cases (11.3%) and mood disorders in 12 cases (8.5%). Among anxiety disorders, acute stress disorder (n=39) and post-traumatic stress disorder (PTSD) (n=27) were the most accounted ones. In 27 cases of the 142, it was determined that, psychiatric symptoms and findings did not cover the diagnostic criteria. Being diagnosed as having a psychiatric disorder did not significantly associated with traumatic experiences, comorbidity, marriage status, education level, and lack of health insurance. Conclusion: We assume that, the presence of a psychological trauma is crucial to be introduced not only for the health benefit but also for legal rights of the patient. The necessity of considering merely the international diagnostic criteria in determining the existence of psychiatric trauma and its severity level can bring forth some difficulties in medico-legal evaluation.