Stress and Trauma Symptoms Associated with Psychiatric Hospitalization in Canada

Objective: The impact of iatrogenic trauma related to psychiatric hospitalization can be significant. However, teasing out stress and trauma symptoms resulting from the hospital admission versus pre-existing diagnoses can be challenging, which may mean that patients’ adjustment reactions to hospitalization, and future illness behaviours, are ignored or misunderstood. This study aims to address this issue by assessing a) the incidence of stress and trauma symptoms arising from acute psychiatric hospitalization, b) how experiencing/witnessing control measures, or abuse, relate to stress, trauma, and healthcare satisfaction, and c) whether certain populations are more vulnerable to stress and trauma compared to others. 

Methods: A cross-section of adult patients (N=157, Mage=40.7 years, SD=15.1) completed a voluntary online survey during psychiatric hospital admission, containing demographic and clinical questions and 3 scales measuring stress, trauma, and healthcare satisfaction. Descriptive statistics, correlation analysis and ANOVA were used to determine the incidence of admissionrelated stress and trauma symptoms, relations between these outcomes and hospital experiences, and whether results differed by demographic group. 

Results: Patients reported relatively low stress and moderate to high satisfaction; however, over 50% met criteria for trauma, and many reported experiencing and/or witnessing control measures, which positively correlated with stress and trauma symptoms. Patients who were Canadian-born, younger, employed, single/ separated, “non-white”, and had psychotic disorders, reported higher stress and trauma symptoms. 

Conclusions: Findings highlight the importance of teasing out admission-related stress vs trauma symptoms, and what kinds of inpatient experiences are associated with these outcomes. Further research is warranted to extend these findings and further explore how demographics and legal status play a role.