Physical injury and depression in six low- and middle-income countries: A nationally representative study

Background:Studies on the association between physical injury and depression in low- and middle-incomecountries (LMICs) are scarce. Therefore, our goal was to analyze the association between physical injury anddepression using nationally representative data from six LMICs.Methods:Cross-sectional data from the Study on Global Ageing and Adult Health (SAGE) survey (2007-2010)were analyzed (N= 42,489). Questions based on the World Mental Health Survey version of the CompositeInternational Diagnostic Interview were used for the endorsement of past 12-month DSM-IV depression. Anyinjury in our analysis referred to having experienced traffic injury or other injury in the past 12 months.Multivariable logistic regression analysis and meta-analyses were used to assess associations.Results:Overall, the prevalence of depression was higher among those who had any injury compared to thosewithout injuries (9.0% vs. 3.7%). Compared to having no injury, any injury without disability was associatedwith a 1.72 (95%CI=1.18-2.50) times higher odds for depression, while the odds for injury with disability wasmuch higher (OR =3.81; 95%CI=2.16-6.73). The pooled estimate (OR) for the association between any injuryand depression based on a meta-analysis using country-wise estimates was 3.28 (95%CI = 1.71-6.31) and amoderate level of between-country heterogeneity was observed (I2= 63.1%).Limitations:Causality or temporal associations cannot be established due to the cross-sectional nature of thestudy.Conclusions:Personalized mental health care to victims of physical injury may reduce risk for depression.Treating disability as the result of injuries may also be effective in the prevention of depressive disorders.