Long-term mental health outcomes after unintentional burns sustained during childhood: a retrospective cohort study

Abstract

BackgroundBurns are a devastating injury that can cause physical and psychological issues. Limited data exist on long-term mental health (MH) after unintentional burns sustained during childhood. This study assessed long-term MH admissions after paediatric burns.MethodsThis retrospective cohort study included all children (< 18 years) hospitalised for a first burn (n = 11,967) in Western Australia, 1980–2012, and a frequency matched uninjured comparison cohort (n = 46,548). Linked hospital, MH and death data were examined. Multivariable negative binomial regression modelling was used to generate incidence rate ratios (IRR) and 95% confidence intervals (CI).ResultsThe burn cohort had a significantly higher adjusted rate of post-burn MH admissions compared to the uninjured cohort (IRR, 95% CI: 2.55, 2.07–3.15). Post-burn MH admission rates were twice as high for those younger than 5 years at index burn (IRR, 95% CI 2.06, 1.54–2.74), three times higher for those 5–9 years and 15–18 years (IRR, 95% CI: 3.21, 1.92–5.37 and 3.37, 2.13–5.33, respectively) and almost five times higher for those aged 10–14 (IRR, 95% CI: 4.90, 3.10–7.76), when compared with respective ages of uninjured children. The burn cohort had higher admission rates for mood and anxiety disorders (IRR, 95% CI: 2.79, 2.20–3.53), psychotic disorders (IRR, 95% CI: 2.82, 1.97–4.03) and mental and behavioural conditions relating to drug and alcohol abuse (IRR, 95% CI: 4.25, 3.39–5.32).ConclusionsOngoing MH support is indicated for paediatric burn patients for a prolonged period after discharge to potentially prevent psychiatric morbidity and associated academic, social and psychological issues.

Depression and Anxiety in Correlation to Body Areas Involved in Patients of Burns

“…In this study it is noted that in 83.9% of participants total body surface area involved in burn injury was up to 25% similar results are seen in study done by Fauerbach 14 , but these results are different from the result of study done by duke et al, that has shown that total body surface area involved in burn injury was up to 25% in 46% of participants 15 . On the contrary there is a study by Vetrichevvel et al, that has noted that in 59% of participants the total body surface area involved after burn was >25% 16 .…”

“…Duke et al, in his study has noted that 32.6% develop anxiety after burn injuries while 27.8% develop depression 15 . Alvi in her study reported that 82% of individuals with burn injuries develop anxiety while 58% individuals with burn injuries develop depression 7 .…”

“On the Recovery Journey:” An Integrative Review of the Needs of Burn Patients From Immediate Pre‐Discharge to Post‐Discharge Period Using the Omaha System

“…Twenty‐two quantitative and 10 qualitative studies were included. Four focused on pediatric burn survivors (Duke et al, 2018; Maskell, Newcombe, Martin, & Kimble, 2013; Sveen, Sjöberg, & Öster, 2014; Willebrand et al, 2011); 25 studies focused on adults (Abrams, Ogletree, Ratnapradipa, & Neumeister, 2016; Bayuo, Agbenorku, & Amankwa , 2016; Christiaens et al, 2015; Elsherbiny, Salem, El‐Sabbagh, Elhadidy, & Eldeen, 2011; Goyatá & Rossi, 2009; Hunter et al, 2013; Idrees, Faize, & Akhtar, 2017; Jang, Park, Chong, & Sok, 2017; Johnson, Taggart, & Gullick, 2016; Juozapavicien, Rimdlka, & Karbonskiene, 2012; Kornhaber, Wilson, Abu‐Qamar, & McLean, 2014; Liang, Wang, Yao, Pan, & Wang, 2012; Martin, Byrnes, McGarry, Rea, & Wood, 2017; Mashreky et al, 2008; Ohrtman et al, 2018; Park, Choi, Jang, & Oh, 2008; Pfitzer et al, 2016; Shahid, Ismail, & Khan, 2018; Sproul, Malloy, & Abriam‐Yago, 2009; Titscher, Lumenta, Kamolz, Mittlboeck, & Frey, 2010; Wasiak et al, 2014; Wiechman et al, 2018; Yuxiang et al, 2012; Zamanzadeh, Valizadeh, Lotfi, Salehi, & Khalili, 2016; Zhang et al, 2014); and three studies focused on both adults and children with burns (Ahuja, Mulay, & Ahuja, 2016; Simons, Price, Kimble, & Tyack, 2016; Vetrichevvel et al, 2018).…”

“…Expressions of guilt and insecurity (Abrams et al, 2016; Zamanzadeh et al, 2016) and feelings of being fed up and ambivalent (Simons et al, 2016) were also noted in the postdischarge period. The presence of scarring is associated with feelings of shame, body dissatisfaction, and the need to conceal (Duke et al, 2018; Hunter et al, 2013). Burns to the hands, face, and neck also evoked more psychological distress among adults (Duke et al, 2018; Titscher et al, 2010; Kornhaber et al, 2014; Zhang et al, 2014).…”

“…The presence of scarring is associated with feelings of shame, body dissatisfaction, and the need to conceal (Duke et al, 2018; Hunter et al, 2013). Burns to the hands, face, and neck also evoked more psychological distress among adults (Duke et al, 2018; Titscher et al, 2010; Kornhaber et al, 2014; Zhang et al, 2014). Females were observed to have worse psychological distress compared to males with burns (Hunter et al, 2013; Wasiak et al, 2014; Zhang et al, 2014).…”