Longitudinal depressive and anxiety symptoms of adult injury patients in Kenya and their risk factors

Abstract

Background: Injuries account for a significant proportion of the health and economic burden for populations in low- and middle-income countries. However, little is known about psychological distress trajectories amongst injury survivors in low- and middle-income countries.

Methods: Adult injury patients (n = 644) admitted to Kenyatta National Hospital in Nairobi, Kenya, were enrolled and interviewed in the hospital, and at 1, 2–3, and 4–7 months after hospital discharge through phone to assess depressive and anxiety symptoms and level of disability. Growth mixture modeling was applied to identify latent trajectories of depressive and anxiety symptoms.

Results: Elevated depressive and moderate-level anxiety symptoms (13%) and low depressive and anxiety symptoms (87%) trajectories were found between hospitalization and up to seven months after hospital discharge. Being female, prior trauma experience, longer hospitalization, worse self-rated health status while in the hospital, and lack of monetary assistance during hospitalization were associated with the elevated symptoms trajectory. The higher symptoms trajectory associated with higher disability levels after hospital discharge and significantly lower proportion of resuming daily activities and work.

Conclusion: The persistence of elevated depressive symptoms and associated reduced functioning several months after physical injury underscores the importance of identifying populations at risk for preventive and early interventions.

Implications for Rehabilitation

• Health providers following up with injury survivors should screen for depressive and anxiety symptoms

• Special attention to women and people with a potential traumatic exposure history

• Incorporation of evidence-based culturally adapted psychosocial interventions in rehabilitation and outpatient clinics

Keywords:

• Adult
• depression
• anxiety
• injuries
• hospitalization
• Kenya

Acknowledgement

The authors would like to thank all the individuals who have participated in this study, and the data collectors for their work recruiting participants and conducting interviews.

Disclosure statement

None of the other authors declare a conflict of interest.

Additional information

Funding

Yuen W. Hung was supported by PAMT training grant (T32 DA017629) from the National Institute on Drug Abuse. The content is solely the responsibility of the authors and does not necessarily represent the official views of the National Institute on Drug Abuse or the National Institutes of Health.