Hospital Based Anxiety and Depression in Post-Fracture Patients in Government and Private Hospitals of Lahore

Abstract

Background: Orthopedic trauma from road traffic accidents (RTAs) is frequently associated with psychological sequelae, particularly anxiety and depression, which may delay recovery and impair quality of life. The hospital environment itself may further influence these outcomes, yet few studies have directly compared public and private healthcare settings in low- and middle-income countries. Objective: To determine the prevalence of anxiety and depression among post-fracture patients admitted to government and private hospitals in Lahore and to examine whether hospital type is associated with psychological morbidity. Methods: A comparative cross-sectional observational study was conducted over six months in Lahore General Hospital (government) and Ittefaq Hospital (private). Ninety-four patients aged 18–39 years with musculoskeletal fractures from RTAs were recruited using purposive sampling. The Hospital Anxiety and Depression Scale (HADS) was administered, and outcomes were analyzed using chi-square tests with odds ratios and 95% confidence intervals. Results: Abnormal anxiety was identified in 36.2% and abnormal depression in 45.7% of participants. Patients in government hospitals were significantly more likely to experience abnormal anxiety (46.8% vs. 25.5%; OR 3.38, 95% CI 1.27–9.01, p=0.028) and abnormal depression (55.3% vs. 36.2%; OR 2.55, 95% CI 1.01–6.44, p=0.045) compared to private hospital patients. Conclusion: Anxiety and depression are highly prevalent among post-fracture inpatients, with greater burden observed in government hospitals. Routine psychological screening, improved hospital environments, and targeted mental health support are essential to optimize recovery.