Epidemiology of burn injuries II: Psychiatric and behavioural perspectives

Abstract

Modern technological advances have decreased the incidence and severity of burn injuries, and medical care improvements of burn injuries have significantly increased survival rates, particularly in developed countries. Still, fire-related burn injuries are responsible for 300,000 deaths and 10 million disability-adjusted life years lost annually worldwide. The extent to which psychiatric and behavioural factors contribute to the incidence and outcomes of these tragedies has not been systematically documented, and the available data is often insufficient to reach definitive conclusions. Accordingly, this article reviews the evidence of psychiatric and behavioural risk factors and prevention opportunities for burn injuries worldwide. Psychiatric prevalence rates and risk factors for burn injuries, prevalence and risks associated with 'intentional' burn injuries (self-immolation, assault, and child maltreatment), and prevention activities targeting the general population and those with known psychiatric and behavioural risk factors are discussed. These issues are substantially interwoven with many co-occurring risk factors. While success in teasing apart the roles and contributions of these factors rests upon improving the methodology employed in future research, the nature of this entanglement increases the likelihood that successful interventions in one problem area will reap benefits in others.

Substance use and misuse in burn patients: Testing the classical hypotheses of the interaction between post-traumatic symptomatology and substance use

“…Alcoholism was proposed as the most reliable predisposing factor in a classical study carried by MacArthur and Moore 9 . McKibben et al 1 reviewed rates of alcohol and substance use disorders in different samples of patients admitted to burn units. Alcohol misuse rates among participants of burn studies seem to be high (32-41%) although comparisons with the general population are not always feasible, as the methodologies used are different from population-wide studies.…”

Children with burn injuries-assessment of trauma, neglect, violence and abuse

“…34 This is further reflected by a 30% mortality rate compared to 2% from accidental burns. 22 Children in these situations are, on average, between two and four years of age, more commonly are boys and come from low-socioeconomic households of two or more children, with most often the abused child being the youngest.…”

The effect of self-care nursing intervention model on self-esteem and quality of life among burn patients

“…The degree of damage done by burn injuries mainly affects the psychological well-being of the person especially if it involves the facial region. [6,7] The study conducted by Van Loey et al [8] and Sidel et al [9] revealed that over 40% of burn patients required psychiatric treatment two years after the trauma and several patients (13%-45%) exhibited a post-traumatic stress disorder which begin at the time of the accident, remain during hospitalization, and may persist for years after hospital discharge. The rehabilitation process includes difficulties in performing physical activities due to scar contractures and pain, which are inherent to the treatment of scars after hospital discharge and obstacles in returning to social activities.…”