Psychological distress after major burn injury
Psychosomatic medicine, 2007•journals.lww.com
Objective: To track the prevalence and stability of clinically significant psychological distress
and to identify potentially modifiable inhospital 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 …
and to identify potentially modifiable inhospital 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 …
Abstract
Objective:
To track the prevalence and stability of clinically significant psychological distress and to identify potentially modifiable inhospital 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≥ 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.
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