PSYCHIATRIC ASPECTS IN BURN PATIENTS

After an epidemiological analysis of psychiatric disorders as a consequence of burns and also psychiatric aspects of burn victims before the accident, this paper discusses the correlation between psychiatric disorders and burns from the epidemiological, etiopathogenetic and clinical-therapeutic aspects. Burn patients often suffer from psychiatric disorders and there is a clear connection between the extent and/or severity of injuries (TBSA) and mental illness, particularly anxiety, mood disorders, and post-traumatic stress disorder. The occurrence of psychiatric disorders (mainly substance or alcohol abuse/dependence, suicidal behaviour, schizophrenia and personality disorders – antisocial or borderline) is a clear-cut risk factor for those with burn injuries. The occurrence or onset of psychiatric illness during burn hospitalization or recovery is a negative factor for wellbeing and also for the quality of life in the medium-long term. A burn injury is a traumatic experience for patients, not only as regards psychological aspects (no integration of the traumatic experience with self-perception of life) but also personal ones (knowledge of self-vulnerability, difficulty in accepting the new aspect of the body, with its possible deformation and scars) after trauma. All aspects which may refer to primordial and psychoanalytic fear of death must be taken into consideration. It is also necessary to consider the concepts of accident proneness and consequent pre-burn impulsivity, which may anticipate/represent a person's predisposition to a traumatic event. All these concepts have clinical and therapeutic importance for multidisciplinary care. This paper focuses on the relationship between burn injuries and psychiatric illness: post-traumatic stress disorder (acute and chronic), affective disorders, and personality traits. They must all be examined not only as regards their outcomes but also the patient's pre-trauma psychopathology and susceptibility. Also of importance is facing therapy for all these disorders and its correlation with burn care (in terms of length of hospital stay, quality of life, and functional and psychological results).