Trauma

Minor trauma is a part of everyday life, and for most people these injuries are of only transient importance, but some have psychiatric and social complications. Most people experience major trauma at some time in their lives.

Detail of Very Slippy Weather by James Gillray (1757-1815)

Psychological, behavioural, and social factors are all relevant to the subjective intensity of physical symptoms and their consequences for work, leisure, and family life. As a result, disability may become greater than might be expected from the severity of the physical injuries.

Psychological and interpersonal factors also contribute to the cause of trauma, and clinicians should be alert to these and their implications for treatment. Tactful questioning, careful examination, and detailed record keeping are essential, especially for non-accidental injury by a patient or others:

• Ask for a detailed description of the cause of the incident

• Ask about previous trauma

• Ask about substance misuse—alcohol and drugs

• Look for patterns of injuries that may be non-accidental, deliberate self harm, or inflicted by others

• Check records

• If suspicious speak to other informants

• Discuss findings and suspicions with a colleague.