274 Occurrence of Psychiatric Illness and Problematic Substance Use among Frostbite Patients in an Urban Verified Burn Center

Abstract

High concordance rates of frostbite injury, substance abuse, and psychiatric illnesses among patients receiving specialized burn treatment have been acknowledged in both scientific literature and clinical lore. Despite this, no recent study has been conducted documenting this phenomenon, and there are no published protocols to guide management of psychiatric comorbidities. Review of the literature shows the last such study was published in 1997. Although understood to be a problem, the challenge of effectively addressing psychosocial factors related to frostbite injury and care has received little attention. To explore the frequency of identified psychiatric diagnoses among patients, this study examined a limited time course (2012-2018) of both inpatient and outpatient clinical records of adult patients treated at an urban verified Regional Burn Center for frostbite injury. A total of 39 patients met inclusion criteria. The patient population was predominately male (77%), with a mean age of 42.5 years (range 22-74 years). Twenty-two patients (56%) were admitted to the burn center and 17 patients (44%) were treated as outpatients. Of the 39 patients reviewed, 65% self-reported substance abuse and/or a preexisting psychiatric illness. Consistent with previous findings, high rates of preexisting psychiatric illness and substance abuse were identified. Results highlight the importance of initial psychiatric and substance abuse screening for identified frostbite patients. If further indicated by screening, full utilization of available social work, psychological, and/or psychiatric services for clinical assessment and treatment recommendations (both while hospitalized and post discharge) is strongly recommended. This study supports a routine psychology and/or psychiatry consult for frostbite patients due to high concordance rates of substance abuse and psychiatric illness.