Assessment of Psychological Impact, Including Post-Traumatic Stress Disorder, in Patients with Maxillofacial Trauma: A Cross-Sectional Observational Study
DOI:
https://doi.org/10.71000/bbvtva22Keywords:
maxillofacial trauma; post-traumatic stress disorder; psychological impact; Impact of Event Scale-Revised; facial disfigurement; PakistanAbstract
ABSTRACT
Background: Maxillofacial trauma can produce visible facial changes, functional impairment, and substantial psychological distress. Post-traumatic stress symptoms may interfere with recovery, social reintegration, and adherence to rehabilitation, yet they remain under-recognized in routine maxillofacial trauma care in Pakistan.
Objective: To estimate the prevalence and severity of probable post-traumatic stress disorder (PTSD) symptoms one month after maxillofacial trauma and to identify demographic and clinical factors independently associated with probable PTSD.
Methods: A hospital-based cross-sectional observational study was conducted in the Department of Oral and Maxillofacial Surgery, Liaquat University of Medical & Health Sciences (LUMHS), Jamshoro/Hyderabad, from late November 2025 to March 2026. Using consecutive sampling, 233 patients aged 12 years or older with maxillofacial trauma were enrolled. The Impact of Event Scale-Revised (IES-R) was administered at one month after injury; a total score ≥35 was classified as probable PTSD for the primary analysis. Associations were examined using Pearson chi-square tests and multivariable logistic regression. A two-sided p-value <0.05 was considered statistically significant.
Results: Among 233 participants, 181 (77.7%) were male, the mean age was 29.4 ± 10.8 years, and road traffic accidents were the most common mechanism of injury (149/233, 63.9%). The mean IES-R total score was 31.3 ± 12.1. Probable PTSD was identified in 63 patients (27.0%; 95% CI: 21.7%–33.1%). Facial disfigurement was associated with a markedly higher prevalence of probable PTSD than absence of disfigurement (42.7% vs. 16.1%; p<0.001), and females had a higher prevalence than males (38.5% vs. 23.8%; p=0.035). In multivariable analysis, facial disfigurement (adjusted odds ratio [AOR] 3.41, 95% CI 1.84–6.32; p<0.001) and female sex (AOR 1.98, 95% CI 1.02–3.85; p=0.043) remained independent predictors, whereas age <35 years and road traffic accident mechanism were not independently associated with probable PTSD.
Conclusion: Probable PTSD symptoms affect approximately one in four patients one month after maxillofacial trauma. Visible facial disfigurement and female sex identify groups with greater psychological vulnerability, supporting routine psychological screening and timely referral as part of multidisciplinary maxillofacial trauma follow-up.
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Copyright (c) 2026 Dr Ishrat Begum Raz, Kashif Ali Channar (Author)
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