Psychiatric consultation and post-traumatic stress disorder in burned patients.

We report a prospective study of 65 burned inpatients referred for psychiatric consultation. All of the subjects in the sample were evaluated by a structured questionnaire and clinical interview. Reasons for referral were: suicide attempt by burning (n = 7), substance dependence (n = 8) and behaviour disturbed by coping difficulties (n = 50). The diagnoses were adjustment disorder (n = 40), alcohol dependence (n = 7), opiate dependence (n = 2), dementia (n = 3), depressive disorder (n = 5), schizophrenia (n = 1), delirium (n = 1) and post-traumatic stress disorder (n = 5). Patients with post-traumatic stress disorder (PTSD) were specifically and carefully evaluated. There were no significant differences between patients with PTSD and adjustment disorder for severity and type of burn injuries. We conclude that PTSD is apt to be missed by the medical staff of burn units.

[The psychiatric consultation-liaison program and posttraumatic stress disorder due to burns]. / Psiquiatría de enlace y trastorno por estrés postraumático en la unidad de quemados.

Sixty-five acute burned inpatients were evaluated prospectively by structured questionnaire and clinical interview. All of the subjects hospitalized in a Burn Unit were referred for psychiatric examination to a psychiatric consultation-liaison programme. Most of the patients suffered adjustment disorders (n = 40), and post-traumatic stress disorder (PTSD) was diagnosed in 5 cases. The carefully assessment of PTSD was an objective of the Study. There were no significant differences among patients with PTSD and Adjustment Disorder for severity and type of burn injuries. The discussion deals with PTSD is a frequent missed disorder by the medical staff of burn units, and also the importance of the patients subjective appraisal of the stressor as a factor precipitating PTSD.