Background\udTraumatic physical injury can result in many disabling sequelae including physical and mental health problems and impaired social\udfunctioning.\udObjectives\udTo assess the effectiveness of psychosocial interventions in the prevention of physical, mental and social disability following traumatic\udphysical injury.\udSearch methods\udThe search was not restricted by date, language or publication status.We searched the following electronic databases; Cochrane Injuries\udGroup Specialised Register, CENTRAL (The Cochrane Library 2009, Issue 1),MEDLINE (Ovid SP), EMBASE (Ovid SP), PsycINFO\ud(Ovid SP), Controlled Trials metaRegister (www.controlled-trials.com), AMED (Allied & Complementary Medicine), ISI Web of\udScience: Social Sciences Citation Index (SSCI), PubMed.We also screened the reference lists of all selected papers and contacted authors\udof relevant studies. The latest search for trials was in February 2008.\udSelection criteria\udRandomised controlled trials that consider one or more defined psychosocial interventions for the prevention of physical disability,\udmental health problems or reduced social functioning as a result of traumatic physical injury.We excluded studies that included patients\udwith traumatic brain injury (TBI).\udData collection and analysis\udTwo authors independently screened the titles and abstracts of search results, reviewed the full text of potentially relevant studies,\udindependently assessed the risk of bias and extracted data.\udMain results\udWe included five studies, involving 756 participants. Three studies assessed the effect of brief psychological therapies, one assessed\udthe impact of a self-help booklet, and one the effect of collaborative care. The disparate nature of the trials covering different patient\udpopulations, interventions and outcomes meant that it was not possible to pool datameaningfully across studies. There was no evidence\udof a protective effect of brief psychological therapy or educational booklets on preventing disability. There was evidence from one trial\udof a reduction in both post-traumatic stress disorder (PTSD) and depressive symptoms one month after injury in those who received\uda collaborative care intervention combined with a brief psycho-educational intervention, however this was not retained at follow up.\udOverall mental health status was the only disability outcome affected by any intervention. In three trials the psychosocial intervention\udhad a detrimental effect on the mental health status of patients.\udAuthors’ conclusions\udThis review provides no convincing evidence of the effectiveness of psychosocial interventions for the prevention of disability following\udtraumatic physical injury. Taken together, our findings cannot be considered as supporting the provision of psychosocial interventions\udto prevent aspects of disability arising from physical injury. However, these conclusions are based on a small number of disparate\udtrials with small to moderate sample sizes and are therefore necessarily cautious. More research, using larger sample sizes, and similar\udinterventions and patient populations to enable pooling of results, is needed before these findings can be confirmed.
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