by Amy Norton
TUESDAY, May 23, 2023 (HealthDay News) — For people who have survived gunshot wounds, trauma may leave mental scars that get worse over time, a new study finds.
Among the 87 adults treated for gun injuries at a trauma center in Wisconsin, symptoms of post-traumatic stress disorder (PTSD) and depression worsened after six months.
The results, published May 22 in Annals of Internal Medicine, It comes from one of the few studies that has tracked the long-term mental health of gunshot victims.
For years, gun violence research in the United States faltered after Congress suspended federal funding for it in 1996. That changed just a few years ago.
“For a long time, we haven’t been able to do firearms research, so we don’t know a lot about these long-term outcomes,” said Dr. Peter Ehrlich, director of the University of Michigan’s Child Trauma Center. C.S. Mott Children’s Hospital.
Ehrlich, who was not involved in the new research, published a study last year that looked at the mental health of American children and teens who sustained gunshot wounds — and the results were similar.
Of the 1,450 children hit by guns, 35% were newly diagnosed with a mental health condition in the following year—most often post-traumatic stress disorder or substance abuse. This compares to the 26% of American children who are injured in a car accident.
Ehrlich said that although the new study was small, it was well done and sheds light on the broader reality.
“There are consequences to gun violence that go beyond the physical,” he said. “There could be long-term effects on mental health.”
The study comes at a time when the number of gun deaths is increasing across the United States. In 2021, such deaths reached a 40-year high — just under 49,000, according to the Giffords Law Center, a nonprofit organization that works to promote gun control.
But many Americans survive gun injuries and then live with the aftermath. According to Giffords, more than 1 million Americans have been shot in the past decade.
For the new study, researchers at the Medical College of Wisconsin, in Milwaukee, followed 87 adults who were being treated at their institution for gun injuries. None of the injuries were self-inflicted.
Patients answered standard questionnaires about mental health symptoms and quality of life related to physical health twice: one month and six months after their injury.
Overall, the study found that symptoms of PTSD and depression got worse over time. At six months, the group’s mean PTSD score exceeded the diagnostic threshold for the condition, while their mean depression score approached the diagnostic marker for this disorder. At both 1 and 6 months, patients typically reported poor quality of life associated with physical health.
Individuals varied widely in how well they functioned, said lead researcher Sydney Timmer Murillo, a postdoctoral fellow in health psychology and trauma.
One question for future studies, she said, is to find out what factors make some people more vulnerable to declining mental health.
According to both researchers, it’s easy to see how gunshot victims often suffer in the aftermath. Many likely live in societies marked by gun violence, which makes recovery from trauma particularly challenging.
“People don’t experience gun violence in a vacuum,” Timur Murillo said.
She said it was crucial that follow-up care for gun injury survivors be “comprehensive” aimed at helping them recover both physically and mentally.
At the Trauma Center in Wisconsin, patients routinely undergo mental health screenings while they are in the hospital recovering from their injury, said Timmer-Murillo. This is, in part, to help overcome the limited access to mental health care that many patients will experience after leaving the hospital.
Although many gunshot survivors do not undergo this screening, Ehrlich said broadly.
In a 2022 study of trauma centers in the United States, researchers found that only a minority routinely screened trauma patients for PTSD or depression, while 30% said they had special screening and treatment programs for gun injury patients.
Recently, though, the American College of Surgeons released new guidelines for trauma centers about mental health screenings — with the goal of identifying those at risk after any traumatic injury.
Specifically, when it comes to gun injuries, Timmer-Murillo noted, survival rates are improving. Then the question is, “What kind of burden are these survivors bearing?” she asked.
Ehrlich agreed, and noted that the issue is not just one big city, but communities across the United States.
“This is a uniquely American problem,” he said.
The advocacy group Everytown for Gun Safety has resources for gun violence survivors.
SOURCES: Sidney Timmer Murillo, Ph.D., Postdoctoral Fellow, Health Psychology and Trauma, Medical College of Wisconsin, Milwaukee; Peter Ehrlich, MD, MSc, Professor of Surgery, Medical Director, Level 1 Pediatric Trauma Center, CS Mott Children’s Hospital, University of Michigan, Ann Arbor; Annals of Internal Medicine, May 22, 2023