Major depression and posttraumatic stress disorder symptoms following severe burn injury in relation to lifetime psychiatric morbidity.
BACKGROUND
Psychiatric history has been suggested to have an impact on long-term adjustment in burn survivors. A rigorous, prospective, longitudinal approach was used to study psychiatric history in a population-based burn sample and its impact on symptomatology of depression and posttraumatic stress disorder (PTSD) at a 12-month follow-up.


METHODS
Seventy-three consecutive patients admitted to the Uppsala Burn Unit were assessed with the Structured Clinical Interview for Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition for psychiatric disorders, of whom 64 were also assessed after 12 months.


RESULTS
Forty-eight patients (66%) presented with at least one lifetime psychiatric diagnosis; major depression (41%), alcohol abuse or dependence (32%), simple phobia (16%), and panic disorder (16%) were most prevalent. At 12-months postburn, 10 patients (16%) met criteria for major depression, 6 (9%) for PTSD, and 11 (17%) for subsyndromal PTSD. Patients with lifetime anxiety disorder and with lifetime psychiatric comorbidity were more likely to be depressed at 12 months, whereas those with lifetime affective disorder, substance use disorder and psychiatric comorbidity were more likely to have symptoms of PTSD.


CONCLUSIONS
Two-thirds of burn survivors exhibit a history of lifetime psychiatric disorders. Those with a psychiatric history have a higher risk of postburn psychiatric problems.
Dyster-Aas
Johan
J
Departments of Neurosciences Psychiatry, University Hospital, Uppsala, Sweden.
Willebrand
Mimmie
M
Wikehult
Björn
B
Gerdin
Bengt
B
Ekselius
Lisa
L
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002053:Burn Units / Q000706:statistics & numerical data*; D002056:Burns / Q000150:complications* / Q000209:etiology; D003865:Major Depressive Disorder / Q000150:complications* / Q000175:diagnosis / Q000453:epidemiology*; D005260:Female; D006801:Humans; D007406:Interview, Psychological; D016015:Logistic Models; D008137:Longitudinal Studies; D008297:Male; D008875:Middle Aged; D015995:Prevalence; D011599:Psychopathology / Q000706:statistics & numerical data*; D013313:Stress Disorders, Post-Traumatic / Q000175:diagnosis / Q000453:epidemiology*; D013548:Sweden / Q000453:epidemiology