Posttraumatic Stress Disorder and Pain Impact Functioning and Disability After Major Burn Injury

Abstract

This study sought to clarify the prospective and concurrent associations of posttraumatic stress disorder (PTSD) and pain with functioning and disability after burn injury. The sample was composed of consecutive patients admitted to a regional burn center with major burn injuries (N = 171) who were followed at 1, 6, 12, and 24 months postdischarge. The predictor measures were the McGill Pain Questionnaire and Davidson Trauma Scale, and the outcome measures were Short Form-36 Health Survey subscales administered at 6, 12, and 24 months after discharge. Linear mixed-effects analyses were conducted to evaluate pain and PTSD as predictors of functional outcomes. Higher PTSD symptom severity soon after hospital discharge was prospectively related to poorer physical and social functioning and greater psychosocial disability (P < .001). However, significant PTSD-by-time interactions also predicted future physical functioning and disability, indicating that the deleterious effects of early PTSD were ameliorated by time. In addition, at each follow-up, PTSD symptoms were concurrently related to greater physical and psychosocial disability, poorer social functioning, and less vitality (P < .001). More severe pain at each follow-up, but not PTSD, was correlated with poorer concurrent physical functioning (P < .002). Significant interaction terms indicated that the concurrent effect of PTSD on psychosocial disability, social functioning, and vitality attenuated during the 24-month recovery period. These findings suggest that assessing PTSD and pain following burn injury may aid in predicting future functioning. Future work should confirm this and evaluate whether aggressively treating both PTSD and pain helps improve functioning after major burn injury.

Health status after traumatic injury

“…Importantly, pain was significantly correlated with poorer physical functioning in a cohort of 171 major burn injury patients. 37 These various results suggest the patients with the greatest potential for benefit from intervention could be identified in the short term after hospital discharge to enable early interventions to commence and that effective treatment may influence functional recovery.…”

Rat an experimental model for burns: A systematic review

“…Among other changes, concerning reintegration into society post discharge, psychological changes are also observed such as post-traumatic stress syndrome in the cases of victims of extensive burns 5,9,10 .…”

Perfil psicológico del paciente gran quemado: prevalencia psicopatológica y variables asociadas

“…En 2010 Corry y col. (19) identifican una prevalencia próxima al 20% en ansiedad y al 10% en depresión. Por ello es importante determinar que el propio proceso de hospitalización podría representar una variable de confusión a la hora de determinar las alteraciones psiquiátri-cas secundarias a las quemaduras.…”