title: Psychiatric consultation and care after acute burn injury: a 6-month naturalistic prospective study.
abstract: OBJECTIVE
  To prospectively investigate proportions of burn patients receiving psychiatric consultation or care, and whether care actually received relates to estimated psychiatric need or burn severity.
  
  
  METHODS
  Consecutive acute hospitalized adult burn patients were examined with the Structured Clinical Interview for DSM IV-TR (SCID-I) at baseline and six months after injury. During follow-up, 55% (51/92) suffered from some mental disorder. Estimated need for psychiatric care was classified as unequivocal, probable or nonexistent. The proportions of patients receiving psychiatric consultation and/or different levels of psychiatric care and specific psychiatric interventions during follow-up and predictors for care were investigated.
  
  
  RESULTS
  During the follow-up, 21% of acute burn patients received psychiatric care, and 20%, psychiatric consultation. Of patients with unequivocal need, 48% (12/25) received psychiatric care, and 28%, psychiatric consultation; with probable need, 21% received psychiatric care, and 37%, consultation. Pre-burn psychiatric history (OR=7.54), severe burns (OR=6.76) and estimated need for psychiatric care (OR=6.23) significantly predicted psychiatric care.
  
  
  CONCLUSIONS
  After hospitalized burn injury, only half of the patients with mental disorders and unequivocal need for psychiatric care actually received such care. Psychiatric consultations and care follow the course of acute burn treatment, not of later emerging mental disorders. Previous psychiatric history strongly influences care decisions.
authors.affiliation: Department of Psychiatry, Helsinki University Central Hospital, Helsinki, Finland. raimo.palmu@hus.fi
authors.forename: Raimo
authors.initials: R
authors.lastname: Palmu
authors.forename: Kirsi
authors.initials: K
authors.lastname: Suominen
authors.forename: Jyrki
authors.initials: J
authors.lastname: Vuola
authors.forename: Erkki
authors.initials: E
authors.lastname: Isometsä
mesh_terms: D000293:Adolescent; D000328:Adult; D002056:Burns / Q000503:physiopathology / Q000523:psychology*; D005260:Female; D005387:Finland / Q000453:epidemiology; D006301:Health Services Needs and Demand; D006801:Humans; D008297:Male; D001523:Mental Disorders / Q000188:drug therapy / Q000453:epidemiology; D008875:Middle Aged; D010361:Patients / Q000523:psychology*; D011446:Prospective Studies; D012017:Referral and Consultation / Q000706:statistics & numerical data*; D015599:Trauma Severity Indices; D055815:Young Adult