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29 - The burns unit

from Part III - Working with specific units

Published online by Cambridge University Press:  10 December 2009

Geoffrey Lloyd
Affiliation:
Priory Hospital, London
Elspeth Guthrie
Affiliation:
University of Manchester
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Summary

Introduction

Burn trauma is a significant cause of mortality and morbidity. In 1999 192 males and 144 females died as a direct result of burn trauma in England and Wales (Office for National Statistics 2000). Frank et al. (1987) estimated that 731 000 emergency room visits and 60 900 hospital admissions occurred annually as a result of burn trauma in the USA. Wilkinson (1998) obtained data from six of the nine accident and emergency departments (AED) that served a UK population of 2.6 million. There were 3013 attendances as a result of burn trauma over a 1-year period representing 1% of the total AED workload.

It is no surprise that burn trauma can result in psychological distress. The burn trauma victim has many issues to contend with. Stressors often include the burn injury itself, pain, hospitalization, reduced functioning and permanent scarring. In addition the burn injury has often been sustained as a result of involvement in a frightening psychologically traumatic event. Individuals who sustain burn trauma also appear more likely to have pre-existing mental health difficulties than the general population (e.g. Patterson et al. 1993).

Nature and prevalence of psychiatric sequelae following burn trauma

Several authors and researchers have considered the psychological impact of burn trauma. The earliest studies were mainly descriptive in nature. Overall, the methodology employed has improved over time. The most recent studies have used well-validated measures to determine the presence of psychological sequelae although unfortunately, like the older studies, have relatively small sample sizes.

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Publisher: Cambridge University Press
Print publication year: 2007

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References

Adler, A. (1943). Neuropsychiatric complications in victims of Boston's Coconut Grove disaster. Journal of the American Medical Association, 123, 1098–101.CrossRefGoogle Scholar
Antebi, D. (1993). The psychiatrist on the burns unit. Burns, 19, 43–6.Google Scholar
Bisson, J. I. (2000). The Effectiveness of Psychological Debriefing for Victims of Acute Burn Trauma. DM Thesis, University of Southampton.
Bisson, J. I. (2002). Post-traumatic stress disorder. Clinical Evidence, 7, 913–19.Google Scholar
Bisson, J., Jenkins, P., Alexander, J., et al. (1997a). A randomised controlled trial of psychological debriefing for victims of acute burn trauma. British Journal of Psychiatry, 171, 78–81.Google Scholar
Bisson, J. I., Shepherd, J. P. and Dhutia, M. (1997b). Psychological sequelae of facial trauma. Journal of Trauma, Injury, Infection and Critical Care, 43, 496–500.Google Scholar
Blank, K. and Perry, S. (1984). Relationship of psychological processes during delirium to outcome. American Journal of Psychiatry, 141, 843–7.Google Scholar
Bowden, M. L., Feller, I., Tholen, D., et al. (1980). Self-esteem of severely burned patients. Archives of Physical Medicine Rehabilitation, 61, 449–52.Google Scholar
Brewin, C. R., Andrews, B. and Valentine, J. D. (2000). Meta-analysis of risk factors for posttraumatic stress disorder in trauma-exposed adults. Journal of Consulting and Clinical Psychology, 68, 748–66.CrossRefGoogle Scholar
Brewin, C. R., Rose, S., Andrews, B., et al. (2002). Brief screening instrument for post-traumatic stress disorder. British Journal of Psychiatry, 181, 158–62.CrossRefGoogle Scholar
Browne, G., Byrne, C., Brown, B., et al. (1985). Psychosocial adjustment of burn survivors. Burns, 12, 28–35.Google Scholar
Bryant, R. A., Harvey, A. G., Dang, S. T., et al. (1998). Treatment of acute stress disorder: a comparison of cognitive-behavioral therapy and supportive counselling. Journal of Consulting and Clinical Psychology, 66, 862–6.CrossRefGoogle Scholar
Difede, J., Jaffe, A. B., Musngi, G., et al. (1997). Determinants of pain expression in hospitalized burn patients. Pain, 72, 245–51.CrossRefGoogle Scholar
Ehde, D. M., Patterson, D. R., Wiechman, S. A., et al. (1999). Post-traumatic stress symptoms and distress following acute injury. Burns, 25, 587–92.CrossRefGoogle Scholar
Frank, H. A., Berry, C., Wachtel, T. L., et al. (1987). The impact of thermal injury. Journal of Burn Care and Rehabilitation, 8, 260–2.CrossRefGoogle Scholar
Green, B. L., Grace, M. C., Lindy, J. D., et al. (1983). Levels of functional impairment following a civilian disaster: the Beverly Hills supper club fire. Journal of Consulting and Clinical Psychology, 51, 573–80.Google Scholar
Kessler, R. C., Sonnega, A., Bromet, E., et al. (1995). Post-traumatic stress disorder in the national comorbidity survey. Archives of General Psychiatry, 52, 1048–60.CrossRefGoogle Scholar
Mendelsohn, I. E. (1983). Liaison psychiatry and the burn center. Psychosomatics, 24, 235–43.CrossRefGoogle Scholar
Neal, L. A., Busuttil, W., Rollins, J., et al. (1994). Convergent validity of measures of post-traumatic stress disorder in a mixed civilian and military population. Journal of Traumatic Stress, 7, 447–55.CrossRefGoogle Scholar
Office for National Statistics. (2000). 1999 Mortality Statistics Cause England and Wales. London: HMSO.
Patterson, D. R., Everett, J. J., Bombardier, C. H., et al. (1993). Psychological effects of severe burn injuries. Psychological Bulletin, 113, 362–78.CrossRefGoogle Scholar
Perry, S. W., Cella, D. F., Falkenberg, J., et al. (1987). Pain perception in burn patients with stress disorders. Journal of Pain Symptom Management, 2, 29–33.Google Scholar
Perry, S., Difede, M. A., Musngi, R. N., et al. (1992). Predictors of post-traumatic stress disorder after burn injury. American Journal of Psychiatry, 149, 931–5.CrossRefGoogle Scholar
Robert, R., Blakeney, P. E., Villarreal, C., et al. (1999). Imipramine treatment in pediatric burn patients with symptoms of acute stress disorder: a pilot study. Journal of the American Academy of Child and Adolescent Psychiatry, 38, 873–82.CrossRefGoogle Scholar
Rose, S., Bisson, J. and Wessely, S. (2001). A Systematic Review of Brief Psychological Interventions (‘debriefing') for the Treatment of Immediate Trauma Related Symptoms and the Prevention of Post-traumatic Stress Disorder. The Cochrane Library, Oxford: Update Software Inc.
Saxe, G., Stoddard, F., Courtney, D., et al. (2001). Relationship between acute morphine and the course of PTSD in children with burns. Journal of the American Academy of Child and Adolescent Psychiatry, 40, 915–21.CrossRefGoogle Scholar
Sgroi, M. I., Willebrand, M., Ekselius, L., et al. (2005). Gerhard. Fear-avoidance in recovered burn patients: association with psychological and somatic symptoms. Journal of Health Psychology, 10, 491–502.CrossRefGoogle Scholar
Sheffield, C. G., Irons, G. B., Mucha, P., et al. (1988). Physical and psychological outcome after burns. Journal of Burn Care and Rehabilitation, 9, 172–7.CrossRefGoogle Scholar
Sonneborn, C. K. and Vanstraelen, P. M. (1992). A retrospective study of self-inflicted burns. General Hospital Psychiatry, 14, 404–7.CrossRefGoogle Scholar
Stanovic, J. K., James, K. A. and Vandevere, C. A. (2001). The effectiveness of risperidone on acute stress symptoms in acute burn patients: a preliminary retrospective pilot study. Journal of Burn Care and Rehabilitation, 22, 210–13.CrossRefGoogle Scholar
Stokes, D. J., Dritschel, B. H. and Bekerian, D. A. (2004). The effect of burn injury on adolescents, autobiographical memory. Behaviour Research and Therapy, 42, 1357–65.Google Scholar
Taal, S. A. and Faber, A. W. (1998). Posttraumatic stress and maladjustment among adult burn survivors 1–2 years postburn. Burns, 24, 285–92.CrossRefGoogle Scholar
Ward, H. W., Moss, R. L., Darko, D. F., et al. (1987). Prevalence of postburn depression following burn injury. Journal of Burn Care and Rehabilitation, 8, 294–8.CrossRefGoogle Scholar
Wiechman, S. A. and Patterson, D. R. (2004). ABC of burns: psychosocial aspects of burn injuries. British Medical Journal, 329, 391–3.CrossRefGoogle Scholar
Wilkinson, E. (1998). The epidemiology of burns in secondary care, in a population of 2.6 million people. Burns, 24, 139–43.Google Scholar
White, A. C. (1982). Psychiatric study of patients with severe burn injuries. British Medical Journal, 284, 465–7.Google Scholar

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