title: The influence of pre-existing psychiatric illness on recovery in burn injury patients: the impact of psychosis and depression.
abstract: We hypothesised that patients with a co-morbid psychiatric illness would show poorer outcomes in recovery from their burn injury compared to patients with equivalent burn injury but without a pre-existing psychiatric illness. A secondary aim was to investigate the effect of self-inflicted burn injury. Consecutive admissions (n = 190) to a burns inpatient unit were screened for the existence of a formal pre-burn psychiatric disorder. Nine patients suffering from psychosis and eight suffering from depression were matched with 18 and 15 patients, respectively not suffering a pre-burn psychiatric disorder on gender, age, burn severity, type, depth and location. Patients with a pre-burn psychiatric diagnosis spent significantly longer in hospital, spent more time in care until discharged from outreach and their burn injuries took longer to heal than matched burn injury patients without a pre-existing psychiatric illness. Time in hospital and to wound healing were significantly greater in psychotic patients compared to their controls but not between depressed patients and their matched controls. Both psychotic and depressed patients had significantly more surgery than their matched controls. Patients whose burn was self-inflicted spent significantly longer in hospital and their wounds took longer to heal. Patients with pre-existing psychiatric conditions, especially psychosis, and those with self-inflicted injuries are associated with difficulties in clinical management and higher economic cost yet staff receive very little specialist training in their management.
authors.affiliation: Academic Division of Clinical Psychology, University of Manchester, Education and Research Building, Wythenshawe Hospital, Manchester M23 9LT, UK. nicholas.tarrier@man.ac.uk
authors.forename: Nicholas
authors.initials: N
authors.lastname: Tarrier
authors.forename: Lynsey
authors.initials: L
authors.lastname: Gregg
authors.forename: Jackie
authors.initials: J
authors.lastname: Edwards
authors.forename: Ken
authors.initials: K
authors.lastname: Dunn
mesh_terms: D000328:Adult; D002056:Burns / Q000150:complications / Q000534:rehabilitation* / Q000601:surgery; D003866:Depressive Disorder / Q000150:complications*; D005260:Female; D006801:Humans; D007902:Length of Stay; D008297:Male; D008875:Middle Aged; D010351:Patient Discharge; D011618:Psychotic Disorders / Q000150:complications*; D012189:Retrospective Studies; D016728:Self-Injurious Behavior / Q000150:complications / Q000534:rehabilitation; D018709:Statistics, Nonparametric; D013997:Time Factors; D016896:Treatment Outcome; D014945:Wound Healing / Q000502:physiology