Objective: Fractures, especially simple fractures, are often seen in patients with psychiatric disorders. These fractures usually occur in the forearms and hands. The psychiatric status of patients with fractures developed during compulsory military service was assessed in this study.
Methods: The data of patients who were admitted to the orthopedic outpatient clinic with acute fractures during the term January 2013 to November 2013 were examined retrospectively. Patients also admitted to the psychiatry polyclinic were included in the study and subjected to further investigation.
Results: Two hundred and sixteen patients with acute fractures were admitted to the orthopedic policlinic of our hospital for the term January 2013 to November 2013. Fracture location was in the hands in 105 of these patients. 44 patients (20%) were also admitted to the psychiatry policlinic and 5 of them had only required surgical treatment. Average psychiatric appeal was 2.4 times. 27 (61%) patients had hand fractures and 7 (15%) patients had isolated ulna fractures. The most common psychiatric diagnosis in these patients was adjustment disorder (75%). 4 patients had anxiety disorder, 1 had dissociative disorder, 1 had depressive disorder, 1 had obsessive compulsive disorder, 1 had phobia and 3 patients had no psychiatric diagnosis. 22 (50%) patients had a history of substance abuse, 15 (34%) patients had history of self-mutilation and 7 (15%) patients had a criminal record.
Conclusion: Hand and isolated ulna fractures are the type of fractures that can be associated with self-mutilation. These fractures are common in patients with psychiatric applications. Tendency to move away from the mandatory environment by self-harm can be seen in patients with adjustment disorder. In addition, this type of behaviors may also express impulsivity symptoms. Patients with adjustment disorder utilize immature defense mechanisms far more often compared to healthy volunteers. Actually, this situation is shown to be the reason for living adjustment problems. Personality disorders are one of the important risk factors for adjustment disorders. Especially antisocial personality disorder has an important place among these personality disorders. Generally, patients with neurotic personality traits experience more problems with adjustment. However, compulsory military service has strict rules, so individuals who have antisocial personality traits undergo more adjustment problems. In this study, the diagnosis of 75% of all patients was adjustment disorder. Also, approximately half of the patients had a history of substance abuse, which is a frequently encountered situation in many antisocial personality and adjustment disorders. All things considered, the result is that the vast majority of patients have antisocial personality traits.