![]() ![]() Of those with pain, 45% reported that pain interfered with their daily lives. found that 52% of burn survivors who were on an average of 10 years after injury reported the presence of pain. Choniere and colleagues found ongoing pain concerns in 35% of a sample of burn survivors, at least 1 year after injury. In addition, pain remains a concern for years after burn injury wounds have closed. Pain is another serious problem for burn survivors, particularly during the early phases of burn care when open wounds are being subjected to debridement and movement therapies. More recent studies have documented that up to 45% of adults who were hospitalised for their burn injury have PTSD 1 year later and that severity of intrusive and avoidant PTSD symptoms within 1 week of injury predicts chronic PTSD. In a study, Cobb and Lindemann described dissociation, re-experiencing, avoidance, and acute grief in those people hospitalised for burns following the Cocoanut Grove fire. Beginning with the work of Cobb and Lindemann in 1943 documenting acute psychological responses to the Cocoanut Grove fire, studies of burn injury have offered perspectives which have helped validate the idea that trauma has mental health consequences. Burn injury has occupied a unique role in the trauma literature. Three of the dissociative symptoms included in the ASD diagnosis (depersonalisation, derealisation, and time distortion/daze) are new to the DSM-IV the other two (numbing, amnesia) have been previously classified as avoidant symptoms within the PTSD diagnosis. The presence of such a wide range of symptoms and syndromes is not at all unexpected, given the plethora of stressors for patients with burns (e.g., burn event, losses, pain, repeated painful procedures, disfiguring injury, and unfamiliar surroundings).Ī diagnosis of PTSD requires the presence of at least one intrusive symptom and three avoidant and two arousal symptoms, each of which must persist for at least 1 month. Prolonged functional impairment has been associated with sleep disturbance, subsyndromal PTSD, depression, body image dissatisfaction, and syndromal PTSD. ![]() Sleep problems, PTSD symptoms, and scar-related problems were highly intercorrelated in a Dutch sample.Īccumulating evidence suggests that psychological distress symptoms have a short- and long-term impact on health, function, and quality of life. Furthermore, many adult Swedish and US burn survivors continue to report nightmares (30–43%) and insomnia (37%) between 1 and 11 years post-burn. Sleep disturbances occur frequently among in-patients with burns, e.g., nightmares in 39% and significant sleep problems in 75%. Body image dissatisfaction appears common in patients with burn injuries. Finally, clinically significant symptoms of depression were reported by 23% in a US sample and 27% in a British sample at 2 years and 20% of Greek patients with burn injuries had a depressive disorder at 2 years.ĭistress may be manifested in other forms as well. In Australian sample, high levels of distress during a major brush fire was more strongly associated with PTSD symptoms than were sociodemographic or preexposure psychological variables. PTSD was more common among veterans with extensive burns than among those with spinal injuries, amputations, major chest trauma, heart failure, or cardiac arrest. Post-traumatic stress disorder (PTSD) has been observed in one-third of Japanese and US samples between 3 and 6 months post-burn, and in 15–20% of Dutch and Greek samples at 1 year. For example, acute stress disorder (ASD) has been reported in 18–26% in Greek, US, and Dutch samples. Stress disorders and depression are prevalent. Severe psychological distress is an important secondary complication of major burn injuries, with long-term consequences. Clinically significant psychological distress also accounted for substantial variance in concurrently assessed quality of life at 2 (58%), 6 (68%), and 12 (51%) months post-burn injury. In addition, psychological distress of in-patients of the hospital predicted significantly greater physical impairment for at least 1 year post-burn. Preliminary reports using the Burn Model System (BMS) dataset indicated that one-third of patients with major burns had clinically significant psychological distress at the time of discharge, and the mean level of psychological distress in the BMS sample was significantly higher than that reflected in published data from a normative sample. Psychological distress is among the most frequent and debilitating complications post-burn injury. ![]()
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