A clinical update on posttraumatic stress disorder in burn injury survivors

McLean, Loyola; Chen, Runsen; Kwiet, Julia; Streimer, Jeffrey; Vandervord, John; Kornhaber, Rachel

doi:10.1177/1039856217700285

Cited by 17 publications

(12 citation statements)

References 24 publications

(34 reference statements)

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“…Future studies should also consider some of the real-world challenges in treating people who have experienced complex childhood traumas. Community clinicians often find that a lengthy period of safety and stabilization is required before survivors can actively engage in processing their trauma (McLean et al, 2017 ) but none of the studies in this review report measuring the nature and length of any such period or investigating its effect on treatment; we therefore recommend that future studies clearly document the prior treatment histories of participants. Furthermore, studies which include use of integrated treatment plans, multidisciplinary interventions and clinician engagements may be more reflective of real world experiences of therapy, including the trust that is built with patients.…”

Section: Discussionmentioning

confidence: 97%

The Efficacy of Eye Movement Desensitization and Reprocessing in Children and Adults Who Have Experienced Complex Childhood Trauma: A Systematic Review of Randomized Controlled Trials

et al. 2018

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Background: Survivors of complex childhood trauma (CT) such as sexual abuse show poorer outcomes compared to single event trauma survivors. A growing number of studies investigate Eye Movement Desensitization and Reprocessing (EMDR) treatment for posttraumatic stress disorder (PTSD), but no systematic reviews have focused on EMDR treatment for CT as an intervention for both adults and children. This study therefore systematically reviewed all randomized controlled trials (RCTs) evaluating the effect of EMDR on PTSD symptoms in adults and children exposed to CT.Methods: Databases including PubMed, Web of Science, and PsycINFO were searched in October 2017. Randomized controlled trials which recruited adult and children with experience of CT, which compared EMDR to alternative treatments or control conditions, and which measured PTSD symptoms were included. Study methodology quality was evaluated with Platinum Standard scale.Results: Six eligible RCTs of 251 participants were included in this systematic review. The results indicated that EMDR was associated with reductions in PTSD symptoms, depression and/or anxiety both post-treatment and at follow-up compared with all other alternative therapies (cognitive behavior therapy, individual/group therapy and fluoxetine) and control treatment (pill placebo, active listening, EMDR delayed treatment, and treatment as usual). However, studies suffered from significant heterogeneity in study populations, length of EMDR treatment, length of follow-up, comparison groups, and outcome measures. One study had a high risk of bias.Discussion: This systematic review suggests that there is growing evidence to support the clinical efficacy of EMDR in treating CT in both children and adults. However, conclusions are limited by the small number of heterogenous trials. Further RCTs with standardized methodologies, as well as studies addressing real world challenges in treating CT are required.

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Section: Discussionmentioning

confidence: 97%

The Efficacy of Eye Movement Desensitization and Reprocessing in Children and Adults Who Have Experienced Complex Childhood Trauma: A Systematic Review of Randomized Controlled Trials

et al. 2018

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“…Physical deformities, and learning or job difficulties, can cause individual and concurrent psychiatric and emotional distress in burn patients (Chou, 2016). Therefore, psychosocial screening and follow-up for burn patients are important, mostly to avoid developing emotional distress or mental illness, especially, posttraumatic stress disorder (PTSD;McLean et al, 2017).…”

Section: Discussionmentioning

confidence: 99%

A Correlational Study of Acute Stress and Resilience Among Hospitalized Burn Victims Following the Taiwan Formosa Fun Coast Explosion

Chen

Weng

et al. 2018

Clin Nurs Res

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Although the survival rate of burn patients in the Formosa Fun Coast Explosion disaster increased significantly, for patients facing long-term rehabilitation, there remained great stress. Therefore, the aim of this study was to explore the predictors of resilience among burn patients in this major disaster. We conducted a cross-sectional, descriptive study in a medical center in northern Taiwan, with a total of 30 burn patients enrolled. Patients' demographics were collected, and the Resilience Scale and Perceived Stress Scale were administered. Multivariate statistical analysis by stepwise and linear regression was used to test these predictors of resilience. The results showed that perceived stress was the key predictor of resilience in the stepwise regression analysis and by adjusting variables including stress level, gender, and education level. These results indicate that the stress level of burn patients should be determined first to provide more targeted methods for reducing stress and improving resilience.

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“…Post-traumatic stress disorder (PTSD) has been found to occur commonly following severe burn injuries. 36 In a large study of 438 patients in the Netherlands, 33% had severe PTSD one to two years post-burn. 37 However, 10 years after a burn injury, QoL is, on average, comparable to the general population.…”

Section: Methodsmentioning

confidence: 99%

The Impact of Acne, Atopic Dermatitis, Skin Toxicities and Scars on Quality of Life and the Importance of a Holistic Treatment Approach

Dréno¹,

Amici²,

Demessant³

et al. 2021

CCID

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Skin conditions such as acne, atopic dermatitis, skin toxicity from oncology treatment, and scars are among the most common health conditions and negatively impact quality of life (QoL). Yet the physician perception of this impact often varies greatly from the patient perception. This is important because patient illness perception is closely linked with seeking help and treatment adherence behaviors. The objective of this review is to better understand the impact of these four highly prevalent skin conditions on QoL including their health-related economic factors to improve treatment outcomes. The literature search included literature published on QoL with acne, atopic dermatitis, scars (from any cause) and skin toxicities on PubMed between 2015 and 2020. We found that patients with skin conditions have a much higher frequency of altered QoL and psychological distress than those without. Also, skin conditions negatively impact self-image and can cause feelings of isolation, loneliness, lower self-esteem, and lower body satisfaction. Additionally, physical discomfort adds to the psychological distress. These physical and psychological impacts are an enormous financial burden on patients, their families and society. We found evidence that holistic treatment including treating the skin condition itself, providing wider peer and psychological support as well as shared decision-making, therapeutic patient education and dermatologist involvement improves outcomes. Holistic history-taking, checklists, or the use of more formal QoL scoring tools can be incorporated into routine consultations to better assess patient well-being and provide clinicians with important information for adapting treatment to individual patient requirements. In conclusion, this review highlights the overall impact of skin conditions (including psychological and QoL impacts) and the importance of providing holistic care to optimize treatment outcomes. A comprehensive QoL screening tool would be useful to help provide patient-centered treatment.

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A clinical update on posttraumatic stress disorder in burn injury survivors

Abstract: The role of the multidisciplinary treatment, integrated and trauma-informed care is essential. While level 1 evidence for PTSD treatments theoretically applies, adaptations that consider comorbidities and treatment contexts are often essential with further research required.

Cited by 17 publications

References 24 publications

The Efficacy of Eye Movement Desensitization and Reprocessing in Children and Adults Who Have Experienced Complex Childhood Trauma: A Systematic Review of Randomized Controlled Trials

The Efficacy of Eye Movement Desensitization and Reprocessing in Children and Adults Who Have Experienced Complex Childhood Trauma: A Systematic Review of Randomized Controlled Trials

A Correlational Study of Acute Stress and Resilience Among Hospitalized Burn Victims Following the Taiwan Formosa Fun Coast Explosion

The Impact of Acne, Atopic Dermatitis, Skin Toxicities and Scars on Quality of Life and the Importance of a Holistic Treatment Approach

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