Firearm injury survivors report PTSD symptoms, poor physical health 6 months later

Key takeaways:

• Survivors of firearm violence had worsened symptoms of depression, stress and anxiety 6 months after injury.
• More research is needed to better understand and manage the mental health consequences.

Survivors of firearm injury face poor physical health-related quality-of-life across time and worsened mental health for at least 6 months, according to researchers.

In the United States, firearm injury is a public health crisis, Sydney C. Timmer-Murillo, PhD, a postdoctoral fellow in health and trauma psychology at the Medical College of Wisconsin, and colleagues wrote in Annals of Internal Medicine.

“Interpersonal firearm violence survivors report significantly worse physical health and functioning compared with the general population and other mechanisms of traumatic injury,” they wrote. “Furthermore, firearm violence impacts the mental health of survivors and communities.”

However, the research examining self-reported mental and physical health consequences of firearm violence for survivors acutely after injury is limited, “thwarting health care systems’ ability to comprehensively intervene.”

“The need to understand the physical and mental health consequences of firearm injury in the United States is vital,” they wrote.

So, Timmer-Murillo and colleagues conducted a preliminary descriptive study to characterize the health-related quality of life and mental health symptoms of firearm injury survivors 6 months after injury.

The researchers recruited a convenience sample of 87 adults with interpersonal firearm-related injuries from a level 1 trauma center in a mid-sized Midwestern city. They pooled data from two studies that took place at the same center between 2014 to 2016 and 2017 to 2021. Both of the studies, they wrote, evaluated the psychological and biological outcomes of traumatic injury.

The participants also completed measures on PTSD, stress, anxiety, depression and physical health-related quality of life.

At baseline, patients reported normal stress levels at a mean score of 9.52. Stress was higher at 6 months, with a mean score of 12.93, but still in the normal range.

The researchers determined that anxiety was “mild” at baseline, with a mean score of 9.28, and “moderate” at 6 months, with a mean score of 11.2.

Depressive symptoms, on the other hand, were “normal” at baseline, with a mean score of 7.25, and higher at 6 months, almost at the cutoff to “mild,” with a mean score of 9.56.

When it came to PTSD, the researchers wrote that patients exhibited symptoms at baseline, with a mean score of 27.15. At 6 months, though, symptoms were more severe, with a mean score of 38.66.

“The PTSD mean score was above the recommended diagnostic cutoff of 34 for PTSD after interpersonal trauma and was higher than previous injury samples,” they wrote.

Aside from mental health outcomes, the researchers found that health-related quality of life was poor at baseline (mean score = 30.48) and remained poor 6 months later (mean score = 30.45), well below scores reported in the general population and previous studies of both injury populations.

“Medical advancements have increased the survivability of firearm injury, though survivors still carry the burden of injury as the mental and physical health outcomes seem poorer relative to the general population and those who have sustained other traumatic injuries,” Timmer-Murillo and colleagues wrote.

They concluded that their findings “must be considered within the context of limitations,” which include relatively short follow-up period, lack of data on preinjury mental health comorbidity and the small convenience sample.

“However, this preliminary study highlights the need to better understand and manage the mental health consequences of firearm injury,” they wrote. “Early screening and comprehensive care may improve outcomes in this at-risk population.”