Effective intervention in Poly-Trauma (PTM) requires psychological and neuropsychological evaluation, multidisciplinary teamwork, and an understanding of a wide range of pain disorders & MBD and their relationships to PTM.
The study determined the Mental & Behavioral Disorder Impairment percentage rating (%MBD), according to the AMA Guides to Evaluation of Permanent Impairment, 6th Edition and examined the relationship between %MBD, health-related quality of life, and functional performance of individuals with Poly-trauma (PTM) history >two year. There has been no previous systematic research on the %MBD from the AMA Guides.
The retrospective study was done on 98 PTM subjects (41 men; ages 28–62) from outpatient rehabilitation clinic records. Main outcome measures were %MBD, SF36-Mental Component Scale (SF36-MCS), and 50-Feet-Walk-Fastest (FWF). Subjects were stratified by %MBD, a mental & behavioral impairment assessment system from the AMA Guides 6th Ed., based on: Brief Psychiatric Rating Scale, Global Assessment of Functioning Scale, and Psychiatric Impairment Rating Scale. SF36-MCS measured the health-related quality of life (HR-QOL), while FWF measured the functional performance status (FPS).
Clinical scores ranged: 5–20%MBD (mean 10.67%); MCS 7.5 to 64 (mean 32.8 normative score); and, FWF 2–30 seconds (mean 12.6). %MBD were mostly in the mild severity, functional performance levels acceptable, but HR-QOL low. There was a trend relationship of the %MBD to the HR-QOL and FPS.
The study supports the medical necessity of providing psychotherapeutic support in individuals with Poly-Trauma to decrease their health burden. Further study on the correlation of %MBD, and SF36-MCS & FPS should be done.