Premorbid Mental Health Research Articles

Comparison of short-term outcomes between people with and without a pre-morbid mental health diagnosis following surgery for traumatic hand injury: a prospective longitudinal study of a multicultural cohort

BackgroundFollowing traumatic hand injury, few studies have compared outcomes between people with and without a pre-morbid mental health diagnosis. This study aimed to compare sub-acute outcomes in a multicultural patient cohort with surgically managed traumatic hand injury with and without a pre-morbid mental health diagnosis.MethodsA prospective, observational cohort study of people with traumatic hand injury presenting pre- surgically to a high-volume hand injury centre in a region of cultural and language diversity was conducted. Participants were assessed face-to-face (baseline) then via telephone (3-months post-surgery) and categorized according to a pre-morbid medically diagnosed mental health diagnosis. Baseline and follow-up assessments included global mental health, and the EuroQol (EQ) ‘Health Today’ analogue scale (0–100) and health domains. Return-to-work status, complications/symptomatic complaints, and hand function (QuickDASH) were also collected at follow-up. Adjusted analyses—accounting for covariates including cultural identity—were conducted to determine whether 3-month outcomes were associated with a pre-morbid mental health diagnosis.ResultsFrom 405 eligible patients, 386 were enrolled (76% male, mean age 38.9 (standard deviation 15.6)); 57% self-identified as Australian and 22% had a pre-morbid mental health diagnosis. Common injuries regardless of pre-morbid mental health diagnosis were skin (40%), tendon (17%) and bone (17%) injuries. None were complex mutilating injuries. Seventy-eight per cent of the cohort was followed-up. In adjusted analyses, a pre-morbid mental health diagnosis was associated with lower odds for reporting ‘good or better’ global mental health (Odds Ratio (OR) 0.23 (95% Confidence Interval (CI) 0.18, 0.47), p < 0.001), ‘no’ anxiety or depression (OR 0.21 (0.11, 0.40), p < 0.001) and no pain (OR 0.56 (0.31, 0.98), p = 0.04)(EQ domains), and worse EQ ‘Health Today’ (10 points on average (95%CI -14.9, -5.1, p < 0.001). QuickDASH scores, rates of complications/symptomatic complaints and return-to-work profiles were similar.ConclusionsDespite reporting worse mental and health-related quality-of-life outcomes post-surgery, people with a pre-morbid mental health diagnosis regardless of cultural identity experienced similar clinical and return-to-work outcomes. Future research assessing the value of screening for pre-morbid mental health conditions on post-surgical outcomes is required and should include people with more complex hand injuries.

Exploring risk factors for persistent neurocognitive sequelae after hospitalization for COVID-19.

In this study of patients hospitalized during acute SARS-CoV2 infection with 6-months of follow-up data, we identified risk factors associated with the development of neuro-PASC. We conducted an exploratory, observational single-center cohort study of patients hospitalized for COVID-19 from November 2020 to March 2022. Our primary outcome was persistent neurocognitive symptoms, defined as fatigue, headache, loss of taste/smell, brain fog, confusion, concentration/memory/word finding difficulty, and/or change in speech present at 1-month and persisting for 6-months following acute SARS-CoV2 infection. Secondary outcomes included persistent impairment scores on PROMIS cognitive function and abilities scales. Multivariate logistic regression analyses identified potential risk factors for neuro-PASC. Of 89 participants, 60% reported persistent neurocognitive symptoms at 6-months; fatigue was the most prevalent, occurring in 53% of participants, followed by brain fog in 34% of participants. Lower self-reported socioeconomic status and increased pre-COVID-19 anxiety scores on the Hospital Anxiety and Depression Scale were associated with increased odds of developing persistent neurocognitive symptoms. Being female and of Hispanic descent were associated with increased odds of persistent cognitive function and ability impairment. Sociodemographic factors and pre-COVID-19 anxiety symptoms may be important risk factors for neuro-PASC. These findings underscore the need to assess various sociodemographic factors in research on PASC. Our study also highlights premorbid mental health symptoms as a potential predictor of persistent neurocognitive symptoms following hospitalization with SARS-CoV2 infection.

Anabolic-androgenic steroids: Considerations for forensic psychiatry, sports psychiatry, and the law

Anabolic-androgenic steroids: Considerations for forensic psychiatry, sports psychiatry, and the law

Concurrent prescribing of opioids with other sedating medications after cancer diagnosis: a population-level analysis.

Cancer is a major reason for concurrent prescription of opioids with other sedating medications-particularly benzodiazepines and gabapentinoids-yet population-based assessments of the extent and predictors of concurrent prescribing among clinically and demographically diverse patients with cancer are lacking. We conducted a retrospective cohort study of patients with non-metastatic cancer using North Carolina cancer registry data linked with Medicare and private insurance claims (2013-2016). We used modified Poisson regression to assess associations of patient characteristic with adjusted relative risk (aRR) of new concurrent prescribing of opioids with benzodiazepines or gabapentinoids after diagnosis. Overall, 15% of patients were concurrently prescribed opioids with benzodiazepines or gabapentinoids. Characteristics independently associated with an increased risk of concurrent prescribing included cancer type (e.g., aRR cervical vs. colorectal cancer: 1.55, 95% CI: 1.12-2.14); prior use of opioids (aRR: 2.43, 95% CI:2.21-2.67), benzodiazepines (aRR: 4.08, 95% CI: 3.72-4.48), or gabapentinoids (3.82, 95% CI: 3.31-4.39), and premorbid mental health conditions, including substance use disorder (aRR: 1.27, 95% CI: 1.05-1.54). Black and Hispanic patients were less likely to experience concurrent prescribing (aRR, Black vs. White: 0.35, 95% CI: 0.15-0.83; aRR, Hispanic vs. White: 0.75, 95% CI: 0.66-0.85). Approximately 1 in 7 patients with cancer was concurrently prescribed opioids with other sedating medications. Associations between patient characteristics and risk of concurrent prescribing highlight predictors of concurrent prescribing and suggest a rationale for systematic assessment of substance use history at diagnosis. Future research could explore inequitable pain and symptom management and investigate risk of adverse medication-related events.

Trajectories and Predictors of Anxiety Over a Ten-year Duration after Traumatic Brain Injury: A TBIMS Study

<h3>Research Objectives</h3> To determine anxiety trajectories across the first 10 years after traumatic brain injury (TBI), and to identify predictors of the longitudinal course of anxiety. <h3>Design</h3> Longitudinal cohort study. <h3>Setting</h3> Community. <h3>Participants</h3> 2836 participants with moderate to severe TBI enrolled in the Traumatic Brain Injury Model Systems (TBIMS) National Database who had anxiety outcomes for ≥2 data collection points over a 10-year follow-up period. <h3>Interventions</h3> N/A. <h3>Main Outcome Measures</h3> Generalized Anxiety Disorder-7 (GAD-7) at 1, 2, 5, and 10-year follow-ups. Relationships were examined with demographic variables, indicators of TBI severity, number of TBIs in addition to the index TBI, pre-morbid mental health, and substance abuse history. <h3>Results</h3> A latent class mixed model identified three anxiety trajectories: low-stable (n=2195), increasing (n=289), and decreasing (n=352). Higher GAD-7 scores were significantly associated with Black race, having public insurance, premorbid mental health problems, experiencing ≥2 additional TBIs with loss of consciousness (LOC), and increased years post-TBI. An interaction between follow-up year and age was also related to GAD-7 scores (p=.001). <h3>Conclusions</h3> Most individuals in the sample had low anxiety that was stable over time (77%). Smaller percentages of individuals had higher levels of anxiety, that either increased (10%) or decreased (13%) as time progressed. Multiple TBI's with LOC were related to greater anxiety up to 10 years after injury. Systemic economic and racial inequities likely contribute to long-term anxiety, as evidenced by greater anxiety in those who had public insurance and/or identified as Black. Younger individuals were more likely to experience an increase in their anxiety over time, suggesting a need for long-term anxiety surveillance, particularly for patients whose TBI occurred at an earlier stage in life. <h3>Author(s) Disclosures</h3> None.

The Burden of Mental Illness Among Survivors of Critical Care—Risk Factors and Impact on Quality of Life: A Multicenter Prospective Cohort Study

Survivors of critical care may demonstrate mental health disorders in the months after discharge. What are risk factors for mental health disorders after ICU discharge and is there an association between the burden of mental illness and health-related quality of life (HRQoL)? Multicenter prospective cohort study that included 579 adult ICU survivors with an ICU stay of > 72h in 10 ICUs. The outcomes were anxiety and depression assessed by the Hospital Anxiety and Depression Scale, posttraumatic stress disorder (PTSD) assessed by the Impact Event Scale 6, and HRQoL assessed by the Short Form 12 version 2. The 6-month prevalences of any mental health disorder were 36.2%(the prevalences of anxiety, depression, and PTSD were 24.2%, 20.9%, and 15.4%, respectively). ICU survivors with mental health disorders showed worse HRQoL scores in both physical and mental dimensions than those without. The higher the number of psychiatric syndromes manifested, the worse the mental dimension of HRQoL. Age of< 65 years (P= .009), history of depression (P= .009), anxiety (P= .003) and depression (P= .02) symptoms at ICU discharge, physical dependence (P= .01), and decreased physical functional status (P= .04) at 6months were associated with anxiety. History of depression (P= .001), depression symptoms at ICU discharge (P< .001), and decreased physical functional status at 6months (P= .01) were associated with depression. Depression symptoms at ICU discharge (P= .01), physical dependence (P= .01), and decreased physical functional status (P= .02) at 6months were associated with PTSD. The network of potential risk factors for mental illness among patients discharged from an ICU is complex and involves multiple factors (age, premorbid mental health, acute emotional stress, and physical impairment after ICU stay). The negative impact of the burden of mental illness on HRQoL among critical care survivors is of concern.

A-32 Acute Concussive Symptom Profiles in Adolescents and Young Adults with History of Depression and Anxiety

Abstract Objective The aims of this study are (1) to examine the clinical symptom profiles of individuals with depression and/or anxiety history following a concussion and (2) to compare profile differences across groups. Method Participants aged 12-25 (n=129, mean=15.6) with premorbid diagnoses of depression (n=24), anxiety (n=50), or depression+anxiety (n=55) were evaluated within 21 days after sustaining a concussion as part of the North Texas Concussion Registry (ConTex) using the Post-Concussion Symptom Scale (PCSS). Following the model described by Kontos and Collins (2014), symptom clusters were derived from the PCSS to create six domains (cognitive/fatigue, vestibular, ocular, posttraumatic migraine, anxiety/mood, cervical). ANOVAs with Tukey’s post-hoc tests were conducted to compare domain symptom severity and total symptom severity across groups. Results There were no demographic differences between groups. A single symptom profile was prominent across each group, with the primary, secondary, and tertiary symptomatic domains being posttraumatic migraine, ocular, and cognitive/fatigue, respectively. Across each domain the depression+anxiety group was most symptomatic, followed in order by the depression and anxiety groups. The depression+anxiety group reported significantly higher anxiety/mood (M=2.0 vs. M=1.3) and cognitive/fatigue (M=2.9 vs M=2.1) symptom severity compared to the anxiety group. Group differences on total symptom severity approached significance (F=2.83, p=.06). Conclusions The observed symptom profiles suggest that the acute-concussive response is similar in adolescents and young adults with history of depression and/or anxiety. Multiple premorbid conditions, such as depression and anxiety, appear to magnify overall symptom severity. Further research is warranted to understand the relationship between symptom burden and premorbid mental health factors.

Amplifying Factors in the Proposed Relationship between Sleep-Wake Dysfunction and Post-Concussion Syndrome Pathogenesis

Objective: Examine factors contributing to the relationship between sleep-wake dysfunction and subacute post-concussion syndrome. Setting: Data collection online via Qualtrics survey. Participants: Forty seven adults reporting recent TBI recruited via Facebook and Reddit. Design: Moderation analysis via hierarchical multiple regression procedure. Main Measures: Neurobehavioral Symptom Inventory, Epworth Sleepiness Scale, Patient Health Questionnaire, General Anxiety Disorder Scale, and a General Health Questionnaire. Results: A relationship between sleep-wake dysfunction and symptoms of subacute post-concussion syndrome was observed. While premorbid mental health did not interact with this relationship, recent endorsement of depression and anxiety symptoms moderated the association. Exploratory analysis also suggested duration of posttraumatic amnesia inflated this relationship. Conclusion: These findings suggest that patients reporting post-concussive sleep dysfunction may benefit from mental health support. They also provide insight in to which early factors may be associated with the development of a sleep-related protracted recovery profile following a traumatic brain injury.

The role of voluntary and involuntary drug and alcohol consumption and premorbid mental health factors in drug-facilitated sexual assault.

In order to better understand risk factors associated with drug-facilitated sexual assault (DFSA), this study examined complainant-specific and contextual factors, as well as the toxicological profile of DFSA in Victoria, Australia. Clinical files and toxicological analysis results collected by the Victorian Institute of Forensic Medicine (VIFM) for all cases of alleged DFSA in Victoria that occurred between 1st January 2011 - 31st December 2013 were reviewed. Two hundred and four cases of alleged DFSA were identified; complainants were predominately female (93%), and their median age was 26years (range = 18-54). Self-reported premorbid depression (21.1%) and drug and alcohol abuse (9.8%) were four and two times higher than 12-month prevalence rates in Australia, respectively. All assailants were male, half were known to the complainant and half of alleged assaults occurred in private residences. Most (93.6%) complainants reported voluntary consumption of psychoactive substances prior to the alleged DFSA. Alcohol was the most commonly self-reported substance consumed (n = 164; 64%) and concomitant use of alcohol, prescription and illicit drugs was also commonly self-reported (24%). There were 14 cases that produced a positive toxicology result where the complainant did not report voluntary consumption, which suggests these drugs may have been used covertly to facilitate sexual assault. The results of this study indicate that Females in their mid-20's who exhibit higher rates of mental health concerns represent a sub-group of the Australian population with increased vulnerability to DFSA, which typically occurs in a familiar setting in the context of voluntary alcohol and other substance use.

Delivery mode is associated with maternal mental health following childbirth.

Childbirth is a life-transforming event often followed by a time of heightened psychological vulnerability in the mother. There is a growing recognition of the importance of obstetrics aspects in maternal well-being with the way of labor potentially influencing psychological adjustment following parturition or failure thereof. Empirical scrutiny on the association between mode of delivery and postpartum well-being remains limited. We studied 685 women who were on average 3months following childbirth and collected information concerning mode of delivery and pre- and postpartum mental health. Analysis of variance revealed that women who had cesarean section or vaginal instrumental delivery had higher somatization, obsessive compulsive, depression, and anxiety symptom levels than those who had natural or vaginal delivery as well as overall general distress, controlling for premorbid mental health, maternal age, education, primiparity, and medical complication in newborn. Women who underwent unplanned cesarean also had higher levels of childbirth-related PTSD symptoms excluding those with vaginal instrumental. The risk for endorsing psychiatric symptoms reflecting clinically relevant cases increased by twofold following unplanned cesarean and was threefold for probable childbirth-related PTSD. Maternal well-being following childbirth is associated with the experienced mode of delivery. Increasing awareness in routine care of the implications of operative delivery and obstetric interventions in delivery on a woman's mental health is needed. Screening at-risk women could improve the quality of care and prevent enduring symptoms. Research is warranted on the psychological and biological factors implicated in the mode of delivery and their role in postpartum adjustment.

Violence-related traumatic brain injury

ABSTRACTObjectives: The purpose of this study was to determine the unique characteristics of violence-related traumatic brain injuries (TBI).Methods: All consecutive patients who underwent head CT due to an acute head injury (n = 3023) at the Emergency Department of Tampere University Hospital (Aug 2010-Jul 2012) were included. A detailed retrospective data collection was conducted in relation to demographics, injury-related data, premorbid health, clinical characteristics, and neuroimaging findings.Results: Patients with violence-related TBIs (n = 222) were compared to patients who sustained a TBI by other mechanisms (n = 2801). Statistically significant differences were found on age, gender, prior circulatory system disease, prior mental or behavioral disorders, chronic alcohol abuse, regular substance abuse, regular medication, alcohol intoxication at the time of injury, narcotics intoxication at the time of injury, and acute traumatic lesion on head CT. The groups did not differ on clinical signs of TBI severity.Conclusions: Young adult males with premorbid mental health history and chronic alcohol abuse are most prone to sustain a TBI due to a violence-related incident. Incidents are often related to alcohol intoxication. However, violence was not consistently associated with more severe TBIs than other mechanisms of injury.

Abstract TP114: Younger Age and Diagnosis of Schizophrenia Increase Door to Needle Times in Acute Ischemic Stroke Patients

Introduction: Faster treatment time for acute ischemic stroke is associated with better outcome. We hypothesized that patient factors such as young age, female sex, premorbid mental health (depression, anxiety, schizophrenia, bipolar) or other conditions (fibromyalgia, chronic pain), may confound making the diagnosis of stroke and thus delay door to needle (DTN) time. Methods: Consecutive patients who received intravenous tPA in our comprehensive stroke center emergency department between January 2015 and June 2018 were reviewed regardless of discharge diagnosis. The primary outcome was DTN time, and secondary outcomes were door to CT imaging (DTI) time and CT read to needle time. Univariate analyses were done using parametric and non-parametric tests and linear regression model was developed with variables with p values &lt;0.15. Results: A total of 225 patients (mean age 63.7 ±15.5 y, 48% women, 67% white, 32% African American, 1.8% other) were identified. Mean DTN was 63 minutes. Patients &lt; 60 y had a mean DTN time of 67.2 minutes vs 60.9 minutes in those &gt; age 60 y (p=0.093). Age &lt;60 was associated with increased mean DTI time (28.6 minutes vs 21.6 minutes in patients &gt; 60; p=0.0068; mean difference of 7 minutes, 95%CI of 2.0, 12.1). There was no significant difference in CT to needle time by age (p=0.77). A known mental health diagnosis or other confounding condition was present in 37%. Four of 225 (1.7%) had schizophrenia, with median DTN time of 91 vs 56 minutes in those without (p=.14). Linear multivariate regression model showed that younger age (p=0.018) and schizophrenia (p=0.009) were independently associated with longer DTN times. Conclusion: Longer DTI times were associated with age less than 60, and longer DTN times were associated with younger age and presence of schizophrenia. Recognition of younger age and schizophrenia by clinicians as confounders could help reduce stroke treatment times.

Mental health history\u2014a contributing factor for poorer outcomes in burn survivors

BackgroundA pre-morbid mental health history is common in patients with severe burn injuries. This creates challenges in providing rehabilitation. The aim of this study is to cross examine the possible impact of psychological co-morbidities on outcomes.MethodsA notes audit was carried out examining patients that were admitted to Concord Hospital Burns Unit in a 3-year period (2010–2012). Patients with total body surface area (TBSA) of 20% or greater and aged between 16 and 50 years were included. Subjects were divided into a mental health group and a control group. SPSS version 21 statistic program was used for analysis the data.ResultsData collected included length of stay, time to achieve independence, %TBSA, types of burns and surgery required. Results of 69 files showed that the average length of stay per %TBSA was nearly double in the patients with a mental health problem (1.47 vs 0.88). They also had a higher rate of re-graft (52% vs 22%) due to infection and poor nutrition. The average time for patients to achieve independence in daily living activity was significantly higher (p = 0.046) in the mental health group (36.2 days) versus the control group (24.1 days).ConclusionPatients with a mental health history may have poorer general health. This may result in a higher failure rate of grafting, leading to a requirement of re-graft. Hence, it took a longer time to achieve independence, as well as a longer hospital stay. A mental health history in burn survivors can be a contributing factor for poorer outcomes in the adult population.

Using a Biopsychosocial Model to Understand Long-Term Outcomes in Persons With Burn Injuries

ObjectiveTo determine the importance of preburn adjustment, injury-related variables, and selection of coping style in various outcome measures using a biopsychosocial model. DesignLongitudinal study. SettingOutpatient burn clinics. ParticipantsBurn survivors (N=231) who participated in this study as part of a larger burn model system study of 645 patients with major burn injuries. InterventionsNot applicable. Main Outcome MeasuresThe 36-Item Short-Form Health Survey was used to assess preburn adjustment. Other outcome measures entered into the model included the Ways of Coping Checklist Revised, the Brief Symptom Inventory, the Beck Depression Inventory-II, and the Davidson Trauma Scale. ResultsCorrelational and mediational analyses revealed that preburn emotional health predicted better adjustment at year 1 and more posttraumatic stress disorder symptoms at year 2. Better preburn emotional health was also related to less use of avoidance coping strategies, which was found to be a mediator of the effect of preburn emotional health and posttraumatic stress disorder symptoms. Burn injury characteristics were not significantly associated with psychological adjustment at either year 1 or year 2. ConclusionsThe results indicate that there is a complex relation between premorbid mental health and the selection of coping strategies that affect long-term adjustment in persons recovering from a burn injury. This relation seems to have greater effect on long-term outcomes than does preburn emotional or physical health alone or the severity of the burn.

The social–ecological context of media use and school success

Theseassociations may be due to the improved employment andfinancial opportunities that high academic achievementallows, but there are likely other explanatory variables--- such as family functioning, child intellectual or self-regulation abilities, stress associated with chronic poverty,or premorbid mental health conditions, which influenceboth academic achievement and later outcomes. Regard-less, identification of potentially modifiable contributors toschool achievement is worthwhile, as improving a child’sacademic trajectory has important life course relevance.A growing literature has examined physical activityas a predictor of school success, with good reason:laboratory-based studiessuggestthatboutsofhigh-intensityphysical activity can improve immediate cognitive func-tioning, such as impulse inhibition and working memory.

Bereavement Needs of Adults, Children, and Families After Cancer

Many families and close friends are experiencing bereavement due to cancer. A review of recent studies of bereavement outcomes, mainly elevated psychological distress, suggests that bereaved family members, compared with nonbereaved, have poorer quality of life. They display high levels of complicated grief, anxiety, and depression and use bereavement services, but also report finding meaning in the loss, during the first 6 months after death. Similar demographic (e.g., female sex and younger age) and psychological (e.g., premorbid mental health conditions and lack of preparedness for the death) predictors are related to the bereavement outcomes across different familial groups. However, the severity of psychological distress and bereavement needs expressed vary by familial groups. Unrelieved pain and anxiety of the patient before the death and family members being unprepared for the impending death appear to be related to several postdeath psychological and physical morbidities of the surviving family members. Although the number of articles addressing bereavement-related issues associated with cancer has been growing in recent years, more rigorous studies that use longitudinal prospective designs, which bridge cancer survivorship with bereavement research, are needed.

P-1168 - Concept of trauma in psychotherapy

Freud says trauma is an external event or excitement strong enough to affect normal psychic activity and defence mechanisms. ICD-10's definition of trauma is: “an event that is outside the range of usual human experience and that would be markedly distressing to almost anyone ”. But what is the role of pre-morbid mental health status and the reason for different presentations in survivors of the same event? The vulnerability theory applies here. Vulnerability in psychic function originates from previous experiences, particularly in childhood when the internal world is still developing and external experiences are able to shape it. Therefore we can summarise that quantity and intensity of an external event would determine whether or not the survivor would be affected by that incident, whereas the quality of interaction between this event and previous experiences of person (vulnerability) would determine the presentation and, particularly, the long term consequences of that traumatic event. In the first 48 hours, the survivor needs and wishes to find something or someone he can perceive, even temporarily, as offering primary maternal care. For many this will be a pressing need to return home. After the first 48 hours, people feel urge to start talking about incidence. These are considered as normal stress reaction. But in some survivors (who are vulnerable), they may remain in the first stage of regression for longer or feel overwhelmed by unmanageable aspects of their experience and show prolonged symptoms known as PTSD. Both of these conditions need outside help and treatment.

Rehabilitation outcomes in people with pre-morbid mental health disorders following spinal cord injury

Case series, consecutive sample. To investigate the rehabilitation outcomes of patients with spinal cord injury (SCI) suffering from preexisting mental health disorders (MHD). National Spinal Injuries Centre (NSIC), Stoke Mandeville Hospital, UK. Twenty-eight newly injured SCI patients: 14 with preexisting MHD and a matched cohort of 14 patients without MHD who were admitted between 2000 and 2006. All patients were involved in a multidisciplinary Goal Planning and Needs Assessment Rehabilitation Programme. Rehabilitation outcomes were measured using the Needs Assessment Checklist (NAC), which has been specifically designed for use with people with SCI. It is a reliable and valid clinical assessment tool, which provides a means to assess and facilitate the delivery of an individually tailored rehabilitation programme. No significant difference was found between the MHD and non-MHD groups for rehabilitation outcomes. The MHD group showed higher achieved independence scores in psychology for the first needs assessment. Overall, both groups were found to make significant improvements in their level of independence for all nine areas of need between the first and second NAC administration. Results suggest that rehabilitation can be tailored to meet the individual needs of patients with SCI having MHD; however, further research comparing these outcomes with other rehabilitation approaches is required. The function of timely psychological support for MHD patients on admission to the NSIC has been suggested as a potential explanation for rehabilitation performance. Most importantly, rehabilitation outcomes of patients with MHD have not been found to differ significantly compared with those without MHD.

Premorbid Mental Health Status of Adult Burn Patients: Comparisons with a Normative Sample

Premorbid Mental Health Status of Adult Burn Patients: Comparisons with a Normative Sample

Post-traumatic stress symptoms and distress following acute burn injury

The occurrence and predictors of acute post-traumatic stress symptoms were assessed in a large, prospective sample of persons with new burn injuries ( N=172). Participants completed a self-report post-traumatic stress symptom checklist, pain ratings, and a premorbid mental health inventory within 24 h of admission to a burn center (Day 1). Over half of the sample reported sleep disturbance and recurrent, intrusive recollections of the burn injury on Day 1. Other commonly endorsed symptoms were difficulties concentrating, avoidance of thoughts/feelings associated with the burn, flashbacks, and exaggerated startle response. Persons with less favorable premorbid mental health and larger burns reported a greater number of stress symptoms on Day 1. These results suggest that experiencing some post-traumatic stress symptoms immediately following a burn trauma is normal. It is recommended that burn care professionals identify and intervene with patients who are suffering clinically significant distress early in the hospitalization.