Having a bad attitude won’t kill you

June 20th, 2007 · No Comments

The notion that a “positive attitude” has beneficial effects on health and wellness has received a lot of attention in the popular press (see here, here, and here). Indeed, there are even studies that show that this “good attitude” even improves outcomes in trauma and critical illness.

Evangelical types tip the boat over and claim that prayer- by family and friends can hasten recovery…Oh please!

But anyway, if folks really believe that spiritual well being (not limited to religion) enhances recovery- than you should expect to see causation run in both directions.. Yes. Basically you might expect that if well being/prayer CAUSES enhanced wellness, that the lack of spiritual well being should be associated with DECREASED wellness… Seems reasonable.

Well if you were to really scrape the bottom of the “spiritual well being barrel” you might come up the suicidal patient.. They’re pretty low I expect..

In comes a group of French MD’s that unknowingly have placed a nail in the proverbial coffin of the idea that spiritual well being has an effect on health.. They ask- Are Patients With Self-Inflicted Injuries More Likely to Die? in the June 2007 issue of Journal of Trauma.

Abstract:
Background: Suicide represents one of the leading causes of trauma in industrialized countries. However, when compared with unintentional injury and assault, the outcome of self-inflicted injury has not been well described.

Methods: All patients admitted to a French academic trauma center from January 2002 to December 2004 and listed in a trauma data bank were included in a prospective analysis. Variables including mortality, circumstances (unintentional vs. assault vs. self-inflicted), and mechanism of injury were recorded.

Results: About 1,004 continuous trauma patients were analyzed: 151 (15%) with self-inflicted injuries, 761 (76%) with unintentional injuries, and 91 (9%) with injuries from assault. When compared with patients suffering from unintentional injuries and assault, self-inflicted injury patients presented more frequently after a fall from height (94 of 151 vs. 133 of 759 and 0 of 91, p < p =" 0.01)">

Conclusions: Self-inflicted injury patients presented with a higher mortality rate that was related to increased injury severity. The circumstances surrounding the trauma were not independently associated with an increased odds ratio of death after major trauma.

So basically, people with self inflicted woulds tended to be more seriously wounded that others, but when patients were matched according to their TRISS scores- probability of survival is identical.

The results: Not surprising, and contrary to the WOO supporters. It’s obvious (to me at least) that the only thing effecting survival after trauma is: