Incidence of Long-Term Psychiatric Complications in Severely Burned Adults

Pain management in severely burned adults: A test of stress inoculation

“…Recent studies have generally supported this view. Of 20 patients evaluated from 1 to 5 years postburn (X = 2.3 years), only 30% were observed to have psychological problems (Andreasen & Norris, 1972;Andreasen et al, 1971). It was noted that these patients were considered to be free of prior psychopathology, and that females were more prone to have difficulty than were males.…”

“…Anxiety reactions have been cited as a common occurrence in almost all burn patients at some time during hospitalization, as well as after discharge (Andreasen, 1974;Andreasen & Norris, 1972;Andreasen et al, 1971, Hamburg et al, 1953bNoyes et al, 1971;Steiner & Clark, 1977). Symptoms such as insomnia, nightmares, and emotional lability usually diminished over time, but were known to persist for several years in some cases.…”

“…Mild to moderate depression of relatively short duration has been observed in a majority of burn patients, while severe depression, characterized by apathy, insomnia, lethargy and longer duration, has been noted in approximately 20% of burn patients (Andreasen, 1974;Andreasen & Norris, 1972;Andreasen et al, 1971Andreasen et al, , 1972aAndreasen et al, , 1972bChanges Herzog, 1976;Hamburg et al, 1953b;Noyes et al, 1971).…”

“…Other problems which have been observed less frequently in burn patients included psychosis, burn encephalopathy, sexual dysfunction, anger and hostility, and problems related to noncompliance with treatment (Aita, 1966;Andreasen et al, 1971Andreasen et al, , 1972aDavidson & Noyes, 1973;Hamburg et al, 1953aHamburg et al, , 1953bKjaer, 1969;Lewis et al, 1963;Quindelen & Abram, 1969;Weisz, 1967). The latter problem has been particularly associated with the existence of premorbid psychopathology (Andreasen et al, 1972a).…”

“…It has been suggested that much unnecessary suffering could be avoided by providing accurate and reassuring information to the patient (Andreasen, 1974;Hamburg et al, 1953a;Kjaer, 1969;Noyes et al, 1971;Weisz, 1967). It has also been recommended that individual supportive psychotherapy or group therapy be available to those patients who need to ventilate their feelings (Andreasen, 1974;Andreasen & Norris, 1972;Andreasen et al, 1971Andreasen et al, , 1972bLewis et al, 1963;Mlott et al, 1977;Noyes et al, 1971). Other suggested treatment strategies have included limit setting, encouraging independent behavior, the use of psychotropic medication, requesting psychiatric consultation, and providing boredom-relieving diversions (Andreasen, 1974;Artz, 1965;Cobb & Lindemann, 1943;Hamburg et al, 1953a;Kjaer, 1969;Weisz, 1967).…”