Psychiatric Disorders in Long-Term Adjustment of At-Risk Adolescent Burn Survivors

Abstract

This study investigated the point prevalence of psychiatric disorders among adolescent long-term burn survivors. Psychiatric symptoms and diagnoses were assessed in 50 youth (30 males, 20 females) characterized as troubled by their parent or guardian on the Child Behavior Checklist from a sample of 93 adolescent burn survivors. Those selected for further evaluation had a mean age at time of burn injury of 4.5 +/- 3.7 years and the mean age at time of diagnostic interview was 14.9 +/- 1.6 years. The average burn injury size among participants was 42 +/- 25% total body surface area. Psychiatric diagnoses were assessed with the computerized diagnostic interview schedule for children. Just over half of these youth (52%) met criteria for one or more psychiatric disorders and many had two or more diagnoses (22%). The most common psychiatric diagnoses were anxiety disorders (36%), followed by substance use (18%) and disruptive behavior disorders (14%). In comparison to previous reports, this study found lower rates of current psychiatric disorders in adolescent burn survivors, even though the participants were considered troubled by a parent. Although there were lower rates of anxiety disorders, especially posttraumatic stress disorder, there were higher rates of substance use disorders and a shift in type of behavior disorders in contrast to previous reports. Although there are limitations in such comparisons, this may indicate changes in the risk factors encountered by adolescent survivors of burn injury.

Psychiatric Morbidity in Pediatric Critical Illness Survivors

“…The studies enrolled 1,067 unique patients. Seven of the studies were conducted in the UK,22, 23, 25–28, 33 five in the US,18,19, 21, 31, 32 two in The Netherlands,24, 29 one in Canada,18one in India,17 and one in Switzerland 30…”

“…17, 19, 22, 23, 25, 29 A majority of studies demonstrated high retention, though only four of the studies described the characteristics associated with participant loss,24, 25, 29, 32 and only four of the studies compared patients lost to follow-up and those that completed the study 18, 20, 24, 29. Over half of the studies adjusted for potential confounders in analyses 18–26, 29, 31, 33…”

Quality of Life of Young Adult Survivors of Pediatric Burns Using World Health Organization Disability Assessment Scale II and Burn Specific Health Scale-Brief

“…35 Using a different instrument, Thomas et al report a much lower prevalence of psychiatric diagnosis in teenagers who were still being treated for their burn injuries. 36 This discrepancy leads us to investigate the time of survey in the current population.…”

Review of Burn Injury Research for the Year 2009

“…More than half of these survivors met the criteria of having one or more psychiatric disorders, including anxiety disorders (36%), substance abuse disorders (18%), and disruptive behavior disorders (14%). 32 This article suggests that children who suffer significant burn injury are at a high risk of developing major psychiatric disorders. Identifying these patients earlier may help them lead productive lives.…”