TitlePsychological distress after major burn injury.
Publication TypeJournal Article
Year of Publication2007
AuthorsFauerbach JA, McKibben J, Bienvenu JO, Magyar-Russell G, Smith MT, Holavanahalli R, Patterson DR, Wiechman SA, Blakeney P, Lezotte DC
JournalPsychosom Med
Volume69
Issue5
Pagination473-82
Date Published2007 Jun
ISSN1534-7796
KeywordsAdult, Burns, Cohort Studies, Female, Humans, Male, Middle Aged, Prevalence, Prospective Studies, Stress, Psychological, Survivors
Abstract

OBJECTIVE: To track the prevalence and stability of clinically significant psychological distress and to identify potentially modifiable in-hospital symptoms predictive of long-term distress (physical, psychological, and social impairment).

METHOD: We obtained data from the Burn Model Systems project, a prospective, multisite, cohort study of major burn injury survivors. The Brief Symptom Inventory (BSI) was used to assess symptoms in-hospital (n = 1232) and at 6 (n = 790), 12 (n = 645), and 24 (n = 433) months post burn. Distress was examined dimensionally (BSI's Global Severity Index (GSI)) and categorically (groups formed by dichotomizing GSI: T score > or =63). Attrition was unrelated to in-hospital GSI score.

RESULTS: Significant in-hospital psychological distress occurred in 34% of the patients, and clinically significant and reliable change in symptom severity by follow-up visits occurred infrequently. Principal components analysis of in-hospital distress symptoms demonstrated "alienation" and "anxiety" factors that robustly predicted distress at 6, 12, and 24 months, controlling for correlates of baseline distress.

CONCLUSIONS: This is the largest prospective, multisite, cohort study of patients with major burn injury. We found that clinically significant in-hospital psychological distress was common and tends to persist. Two structural components of in-hospital distress seemed particularly predictive of long-term distress. Research is needed to determine if early recognition and treatment of patients with in-hospital psychological distress can improve long-term outcomes.

DOI10.1097/psy.0b013e31806bf393
Alternate JournalPsychosom Med
PubMed ID17585064