577 The Intersection Between Burns and Psychiatric Disorders

Abstract

Abstract Introduction Burns constitute a major health problem accounting together with fires for more than 300.000 deaths per year worldwide and for a great rate of disability-adjusted life years (DALYs). Identifying the relationship between mental disorders and burns is crucial since the former seems to constitute an important risk factor for the latter. At the same time, clinical experience and scientific evidence suggest that survivors of burns often develop psychiatric sequelae, causing poorer outcomes and lower quality of life. Methods We conducted a systematic review in order to study the relationship between burns and psychopathology as well as the quality of life. We used the search engine “PubMed” with the term “((psychiatric[Title/Abstract]) OR psychological[Title/Abstract]) AND burns[Title/Abstract]” without limits regarding the time of publication, resulting in 761 studies. Using the Covidence online platform that enables screening of the articles by two reviewers, we screened the articles, first by title and abstract and then by full text. Non-English papers or papers with no full texts will be excluded from the study. We aim to register the review in the official international prospective register of the National Institute for Health Research (PROSPERO). Results Preliminary results suggest that a history of mental disorder is common among burn patients, whether self-inflicted or not. Research tends to focus on self-inflicted burns which are expected to show such an association. Indeed, psychotic disorders, drug dependence and depression constitute significant risk factors for self-immolation. At the same time, the presence of a mental disorder may be associated with a worse prognosis (burn complications, patient morbidity, and mortality, multiple hospitalizations, increased cost for treatment). Burn survivors are also at risk for developing psychiatric complications, such as Post Traumatic Stress Disorder (PTSD), depression and anxiety disorders, as well as experiencing a lower quality of life. It appears that the disfigurement, loss of function and change in body image perception caused by the burns lead to the emergence or recurrence of a psychiatric condition. Last but not least, the relationship between delirium in the Burns Intensive Care Unit patients is well established. Conclusions There seems to exist a significant ambidirectional connection between burns and mental disorders. Higher rates of mental disorders among burn patients in the pre- and post-burn period complicate the situation and lead to poorer results if left untreated. Applicability of Research to Practice Identifying risk factors for burns associated with the medical history, early recognition and appropriate treatment of mental disorders after the burn incident, improving rehabilitation and psychosocial re-integration of this patient population.