title: The presence of nightmares as a screening tool for symptoms of posttraumatic stress disorder in burn survivors.
abstract: Recurrent nightmares can be a symptom of posttraumatic stress disorder (PTSD). This study evaluated the method of asking burn survivors about nightmares as a screening tool for the presence of PTSD symptomatology. The presence of nightmares in 85 individuals treated at the Burn Center in Uppsala, Sweden, between 1996 and 2000 (23 women, 62 men, average age 47 years, average burn size 17% TBSA, average time after burn 3.6 years) was evaluated by one question from the Burn Specific Health Scale (BSHS) and by using the Diagnostic and Statistical Manual of Mental Disorders, 4th edition criteria for nightmares. PTSD symptomatology was assessed with the Impact of Event Scale-Revised. Sensitivity, Specificity, Discriminant Ability, and Likelihood Ratios for a positive and a negative result were calculated to evaluate the screening questions. As many as 46% of the burn survivors reported nightmares of some frequency in the BSHS and as many as 28% when using the Diagnostic and Statistical Manual of Mental Disorders, 4th edition criteria. Both approaches were useful tools for detecting or ruling out PTSD symptoms. The best Discriminant Ability was achieved with a screening test using the BSHS item "I have nightmares." Screening questions for presence of nightmares after burns can be useful in detecting PTSD symptomatology.
authors.affiliation: Department of Surgical Sciences, Plastic Surgery, Akademiska sjukhuset Uppsala, Uppsala, Sweden.
authors.forename: Aili Janina F
authors.initials: AJ
authors.lastname: Low
authors.forename: Johan
authors.initials: J
authors.lastname: Dyster-Aas
authors.forename: Morten
authors.initials: M
authors.lastname: Kildal
authors.forename: Lisa
authors.initials: L
authors.lastname: Ekselius
authors.forename: Bengt
authors.initials: B
authors.lastname: Gerdin
authors.forename: Mimmie
authors.initials: M
authors.lastname: Willebrand
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002056:Burns / Q000523:psychology*; D003430:Cross-Sectional Studies; D004325:Dreams; D005260:Female; D006801:Humans; D008297:Male; D008403:Mass Screening / Q000379:methods*; D008875:Middle Aged; D011237:Predictive Value of Tests; D011569:Psychiatric Status Rating Scales; D012680:Sensitivity and Specificity; D013313:Stress Disorders, Post-Traumatic / Q000175:diagnosis*; D011795:Surveys and Questionnaires; D017741:Survivors / Q000523:psychology*; D013548:Sweden