Am J Psychiatry 1992; 149:1234-1238
Copyright © 1992 by American Psychiatric Association
Posttraumatic adaptation and distress among adult burn survivors
RP Roca, RJ Spence and AM Munster
Department of Psychiatry, Johns Hopkins University School of Medicine, Baltimore, Md.
OBJECTIVE: The purpose of this study was to examine the prevalence, natural
history, and psychosocial impact of posttraumatic symptoms in adult burn
survivors. METHOD: Forty-three adult inpatients at a regional burn center
were assessed at discharge with standardized instruments to determine the
presence of psychiatric disorder, assess personality, and quantify
depression. Thirty-one patients were evaluated 4 months after discharge.
RESULTS: Posttraumatic stress disorder was diagnosed in 7% of patients at
discharge and in over 22% of patients at follow-up. Symptoms of avoidance
and emotional numbing (DSM-III-R criterion C symptoms) tended to emerge
after discharge from the hospital. While posttraumatic symptoms were
associated with symptoms of depression, they were not strongly associated
with psychosocial adjustment to illness; psychosocial adjustment was more
strongly related to aspects of personality, the injury itself, and its
treatment. CONCLUSIONS: Since adult burn survivors often develop new
symptoms of posttraumatic distress after leaving the hospital, longitudinal
surveillance is required to detect new cases and provide appropriate
treatment. Survivors at risk for poor psychosocial adjustment after
discharge may be identifiable during hospitalization, and preventive
treatment strategies should be developed and tested for this population.
