Psychiatric morbidity and functional impairments in survivors of burns, traumatic injuries, and ICU stays for other critical illnesses: a review of the literature.
Severe burns, traumatic injuries and other critical illnesses are a substantial source of morbidity in the United States. As more patients survive these conditions, there has been increasing interest in psychiatric and functional outcomes of these individuals. In this article, we reviewed the literature on the prevalence of psychiatric conditions, with particular emphasis on posttraumatic stress disorder (PTSD) and depression, as well as functional impairments, in adult and pediatric survivors of burns, trauma and intensive care unit stays for other critical illnesses. We found that PTSD and depressive symptoms are quite prevalent in these patient groups. We also examined potential risk factors for psychiatric morbidity and impaired function in all three patient groups, and conclude that patient-specific and acute care factors, in addition to early post-acute care psychiatric symptoms, may convey risk for subsequent psychopathology and diminished function. Finally, we discussed limitations in the literature as well as possible directions for future research, particularly in clarifying risk factors for psychiatric disorders as well as potential preventative and treatment interventions that may improve outcomes.
Davydow
Dimitry S
DS
Department of Psychiatry and Behavioral Sciences, University of Washington School of Medicine, Seattle, Washington 98195, USA. ddavydo1@u.washington.edu
Katon
Wayne J
WJ
Zatzick
Douglas F
DF
D001008:Anxiety Disorders / Q000453:epidemiology / Q000209:etiology; D002056:Burns / Q000150:complications / Q000523:psychology; D016638:Critical Illness / Q000523:psychology*; D003866:Depressive Disorder / Q000453:epidemiology / Q000209:etiology; D006801:Humans; D007362:Intensive Care Units; D015995:Prevalence; D011788:Quality of Life; D012307:Risk Factors; D013313:Stress Disorders, Post-Traumatic / Q000453:epidemiology / Q000209:etiology; D014481:United States / Q000453:epidemiology; D014947:Wounds and Injuries / Q000150:complications / Q000523:psychology*