TY - JOUR
T1 - Psychological distress after major burn injury
AU - Fauerbach, James A.
AU - McKibben, Jodi
AU - Bienvenu, O. Joseph
AU - Magyar-Russell, Gina
AU - Smith, Michael T.
AU - Holavanahalli, Radha
AU - Patterson, David R.
AU - Wiechman, Shelley A.
AU - Blakeney, Patricia
AU - Lezotte, Dennis
PY - 2007/6
Y1 - 2007/6
N2 - 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.
AB - 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.
KW - Burn injury
KW - Burn model systems
KW - Predictors
KW - Prevalence
KW - Prospective
KW - Psychological distress
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U2 - 10.1097/psy.0b013e31806bf393
DO - 10.1097/psy.0b013e31806bf393
M3 - Article
C2 - 17585064
AN - SCOPUS:34250808396
SN - 0033-3174
VL - 69
SP - 473
EP - 482
JO - Psychosomatic medicine
JF - Psychosomatic medicine
IS - 5
ER -