Mental disorders among acute burn patients

Area of Science:

• Psychiatry
• Trauma Care
• Burn Medicine

Background:

• Mental disorders are frequently observed in patients with severe injuries.
• Burn injuries can lead to significant physical and psychological trauma.
• Understanding the prevalence of mental disorders in burn patients is crucial for comprehensive care.

Purpose of the Study:

• To investigate the prevalence of Axis I and Axis II mental disorders in acute burn patients.
• To assess mental disorders in burn patients across different time frames: lifetime, pre-burn, and during acute care.
• To explore the relationship between burn severity and mental health conditions.

Main Methods:

• A cohort of 107 consecutive adult burn patients admitted to Helsinki Burn Centre were interviewed.
• The Structured Clinical Interview for DSM-IV-TR was used by a psychiatrist to diagnose Axis I and II disorders.
• Data collected included clinical features, psychiatric symptoms, personality traits, and burn severity (total body surface area).

Main Results:

• The mean total body surface area burn was 9%.
• 61% of patients had at least one lifetime mental disorder.
• High prevalences of lifetime substance-related (47%), psychotic (10%), and personality disorders (23%) were noted.
• The prevalence of Axis I disorders increased from 40% pre-burn to 48% during acute care (p=0.011).
• Delirium prevalence significantly increased from 0.9% pre-burn to 13% during acute care (p<0.001).

Conclusions:

• Mental disorders, especially substance use, psychotic, and personality disorders, are common in acute burn patients prior to injury.
• These pre-existing conditions may increase susceptibility to burn injuries.
• Burn injuries themselves may contribute to the development of mental disorders, particularly delirium, during acute care.