Psychiatric consequences of needlestick injury.

BACKGROUND Needlestick injuries (NSIs) are a common occupational hazard with potential physical health effects, including viral infections such as hepatitis and HIV. Less appreciated are the psychiatric consequences of NSIs, potentially including post-traumatic stress disorder (PTSD) and adjustment disorder (AD). AIMS To study psychiatric consequences of NSIs by diagnosis, duration and severity of depressive symptoms. METHODS Case control study from patients referred to a psychiatric trauma clinic diagnosed according to ICD-10 diagnostic research criteria guidelines. The Beck Depression Inventory (BDI) was administered to measure depressive symptomatology and assess differences in depression severity between psychiatric trauma patients who had or had not experienced an NSI, and for relationships between the severity of depression and time since NSI using linear models. RESULTS There were 17 NSI cases and 125 controls. NSI patients had moderately severe depressive symptoms (mean BDI score 22.7 15), which was similar to 125 non-NSI trauma patients. 13 of these 17 cases had AD and four had PTSD. None contracted infections from their NSI, but most described secondary effects of psychiatric illness on occupational, family and sexual functioning. Severity of depressive symptoms declined with time after NSI, but psychiatric illness lasted 1.78 months longer for every month a NSI patient waited for seronegative test results (P < 0.05). CONCLUSIONS Enduring psychiatric illness can result from NSIs with a severity similar to other psychiatric trauma. Swift delivery of test results may reduce the duration of depression associated with NSI. Occupational health professionals need to be aware of the psychiatric and physical effects of NSIs.