A population-based comparison study of the mental health of patients with intentional and unintentional burns

Abstract

BackgroundA number of studies report high prevalence of mental health conditions among burn patients. However there is a need to understand differences in the temporal relationship between mental health conditions and intentional and unintentional burns to hasten psychological prevention and intervention. This study aims to compare the socio-demographic profile, burn characteristics and pre- and post-burn psychiatric morbidity of burn patients by intent-of-injury.MethodsDe-identified linked hospital, death and mental health (MH) case registry data of burn patients hospitalised in Western Australia between 1 January 1980 and 30 June 2012 were analysed. Crude (observed) post-burn rates of mental health admissions were generated by burn intent-of-injury. Descriptive statistics were performed to compare the characteristics of the burn patients.ResultsA total of 30,997 individuals were hospitalised for a first burn; 360 (1.2%) had self-harm burns and 206 (0.7%) assault burns. Over the study period, admission rates for assault burns increased by 4.8% per year (95% confidence interval (CI) 3.1–6.5%) and self-harm burns increased 6.9% per year (95% CI 4.8–9.1%). Self-harm and assault burns occurred mainly among those aged 15 to 44 years (median age, interquartile range (IQR): self-harm 30 years, 22–40; assault 31 years, 23–38). Those with self-harm burns had a longer index hospital stay (median (IQR): self-harm 15 days (5–35) vs 4 days (1–11) assault vs 4 days (1–10) unintentional) and higher in-hospital mortality (7.2% self-harm vs 1.9% assault burns vs 0.8% unintentional). More than half (55.0%) of self-harm burns had a prior hospitalisation (5-year lookback) for a MH condition vs 10.7% of assault burns and 2.8% of unintentional burns. Crude post-burn rates of MH admissions per 100 person-years (PY) by intent-of-burn subgroups: self-harm 209 per 100 PY, assault burns 11 per 100 PY and unintentional burns 3 per 100 PY.ConclusionsIntentional burn patients experienced significantly higher pre- and post-burn mental health morbidity along with significant adverse outcome in comparison with unintentional burns. Early psychological assessment and intervention could help in improving the MH of these patients.

Depression and Anxiety in Correlation to Body Areas Involved in Patients of Burns

“…In this study it is noted that in 83.9% of participants total body surface area involved in burn injury was up to 25% similar results are seen in study done by Fauerbach 14 , but these results are different from the result of study done by duke et al, that has shown that total body surface area involved in burn injury was up to 25% in 46% of participants 15 . On the contrary there is a study by Vetrichevvel et al, that has noted that in 59% of participants the total body surface area involved after burn was >25% 16 .…”

“On the Recovery Journey:” An Integrative Review of the Needs of Burn Patients From Immediate Pre‐Discharge to Post‐Discharge Period Using the Omaha System

“…Twenty‐two quantitative and 10 qualitative studies were included. Four focused on pediatric burn survivors (Duke et al, 2018; Maskell, Newcombe, Martin, & Kimble, 2013; Sveen, Sjöberg, & Öster, 2014; Willebrand et al, 2011); 25 studies focused on adults (Abrams, Ogletree, Ratnapradipa, & Neumeister, 2016; Bayuo, Agbenorku, & Amankwa , 2016; Christiaens et al, 2015; Elsherbiny, Salem, El‐Sabbagh, Elhadidy, & Eldeen, 2011; Goyatá & Rossi, 2009; Hunter et al, 2013; Idrees, Faize, & Akhtar, 2017; Jang, Park, Chong, & Sok, 2017; Johnson, Taggart, & Gullick, 2016; Juozapavicien, Rimdlka, & Karbonskiene, 2012; Kornhaber, Wilson, Abu‐Qamar, & McLean, 2014; Liang, Wang, Yao, Pan, & Wang, 2012; Martin, Byrnes, McGarry, Rea, & Wood, 2017; Mashreky et al, 2008; Ohrtman et al, 2018; Park, Choi, Jang, & Oh, 2008; Pfitzer et al, 2016; Shahid, Ismail, & Khan, 2018; Sproul, Malloy, & Abriam‐Yago, 2009; Titscher, Lumenta, Kamolz, Mittlboeck, & Frey, 2010; Wasiak et al, 2014; Wiechman et al, 2018; Yuxiang et al, 2012; Zamanzadeh, Valizadeh, Lotfi, Salehi, & Khalili, 2016; Zhang et al, 2014); and three studies focused on both adults and children with burns (Ahuja, Mulay, & Ahuja, 2016; Simons, Price, Kimble, & Tyack, 2016; Vetrichevvel et al, 2018).…”

“…Mental health issues that were identified were related to pre‐existing psychological disorders such as depression, which worsened after discharge (Ahuja et al, 2016; Vetrichevvel et al, 2018; Wiechman, 2011). Worry, anxiety, and flashbacks from the initial injury occurrence have been reported (Ahuja et al, 2016; Bayuo et al, 2016; Liang et al, 2012; Mashreky et al, 2008; Park et al, 2008; Pfitzer et al, 2016; Shahid et al, 2018), as well as feelings of sadness and helplessness (Elsherbiny et al, 2011) and feelings of alienation and fear (Juozapavicien et al, 2012; Kornhaber et al, 2014; Sveen et al, 2014).…”

Mental Disorders Among Burn Patients During Periods of Shock and Toxemia

“…Частота психических расстройств (ПР) прямо пропорциональна тяжести ожоговой травмы: если при поверхностных ожогах ПР -это редкость, то при глубоких поражениях, превышающих 20% поверхности тела, он возникает у 90% пострадавших [3]. ПР в одних случаях преходящи и связаны только с определенными периодом ожоговой болезни, в других -обнаруживаются на всех этапах болезни, в третьих -сопровождают пострадавшего всю жизнь [3][4][5][6][7][8][9][10].…”