A population-based cohort study of 29,191 adult trauma patients in Western Australia found that among 26,958 patients without preexisting psychiatric conditions, 3,299 (11.3%) developed a new mental health disorder following their trauma admission. These new-onset conditions were linked to significantly higher risks of hospital readmission, suicide, and all-cause mortality over long-term follow-up.

Published in JAMA Network Open, the study used linked health and death registry data between January 1994 and September 2020, with a median follow-up time of 99.8 months (IQR, 61.2–148.5 months). Of the full cohort, 3,868 patients (13.2%) died on or before the study’s censor date.

Among those who developed a new mental health diagnosis post-trauma, 8.2% (n = 2,391) were diagnosed with drug dependence, and 5.4% (n = 1,574) were diagnosed with neurotic disorders, including posttraumatic stress disorder. Additionally, 419 patients (1.4%) developed opioid dependence after trauma, compared with 130 patients (0.5%) who had such a diagnosis before trauma. Anxiety disorders also increased post-injury, affecting 3.1% (n = 896) of patients versus 0.6% (n = 162) pre-injury.

The development of a new mental health condition was associated with a 30% increased risk of trauma readmission (adjusted hazard ratio [aHR], 1.30; 95% CI, 1.23–1.37; P < .001), a 3.14-fold increased risk of suicide (aHR, 3.14; 95% CI, 2.00–4.91; P < .001), and a 24% increased risk of all-cause mortality (aHR, 1.24; 95% CI, 1.12–1.38; P < .001).

Factors independently associated with the development of a post-trauma psychiatric condition included younger age, unemployment, being single, divorced, or separated, Indigenous ethnicity, and lower socioeconomic status. Patients with traumatic brain injury were also at increased risk.

“These findings indicate that mental health follow-up of patients with trauma, particularly in vulnerable subgroups, may be warranted,” said study author Lai Kin Yaw, MBBS, of the Department of Intensive Care, Fiona Stanley Hospital, Murdoch, Western Australia, and colleagues.

The findings align with prior research, including a 2018 population-based study in Ontario that linked major trauma to long-term psychiatric morbidity and increased suicide risk. The authors of the present study emphasized the importance of targeted follow-up and intervention strategies, particularly in high-risk populations.

Full author disclosures and funding information are available in the original article.