• Nicola Pirente, Christine Blum, Silja Wortberg, Sevgi Bostanci, Eva Berger, Rolf Lefering, Bertil Bouillon, Klaus E Rehm, and Edmund A M Neugebauer.
• Institute for Research in Operative Medicine (IFOM), Faculty of Medicine, University of Witten/Herdecke, Ostmerheimer Str. 200, 51109 Cologne, Germany.
• Langenbecks Arch Surg. 2007 Nov 1; 392 (6): 739-45.

Background And AimsThe aim of this study was to improve health-related quality of life (HRQOL) related to depression, anxiety, pain, physical functioning and social aspects for severely injured trauma survivors by early onset cognitive behavioural therapy applied on the surgical ward.Materials And MethodsThe study was a randomised, controlled study. Of 298 primary screened patients 171 were eligible and randomised. Ninety-two patients adhered to follow-up investigations at 6 and 12 months. Main outcome measure was a sum score according to O'Brien calculated of five different questionnaires (BDI, SF-36, STAI, SCL 90R, F-SOZU-22).ResultsThe sum score for overall HRQOL did not show significant group differences at follow-up. Effects on HRQOL sub-dimensions within groups have been found. In the dimension of depression therapy group showed significant improvement from the first measurement to discharge from hospital (p < 0.001), 6 MFU (p = 0.004) and to 12 MFU (p = 0.013). Measures of anxiety showed significant improvement for the therapy group at discharge from hospital (p = 0.001). In the control group there was only a significant reduction in depression and anxiety from surgical ward to discharge (p = 0.013/p = 0.031).ConclusionsEarly onset cognitive therapy is not effective in improving overall HRQOL of severely injured patients but shows promising effects on depression and anxiety up to 12 months after trauma.

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