Roca R P, Spence R J, Munster A M
Department of Psychiatry, Johns Hopkins University School of Medicine, Baltimore, Md.
Am J Psychiatry. 1992 Sep;149(9):1234-8. doi: 10.1176/ajp.149.9.1234.
The purpose of this study was to examine the prevalence, natural history, and psychosocial impact of posttraumatic symptoms in adult burn survivors.
Forty-three adult inpatients at a regional burn center were assessed at discharge with standardized instruments to determine the presence of psychiatric disorder, assess personality, and quantify depression. Thirty-one patients were evaluated 4 months after discharge.
Posttraumatic stress disorder was diagnosed in 7% of patients at discharge and in over 22% of patients at follow-up. Symptoms of avoidance and emotional numbing (DSM-III-R criterion C symptoms) tended to emerge after discharge from the hospital. While posttraumatic symptoms were associated with symptoms of depression, they were not strongly associated with psychosocial adjustment to illness; psychosocial adjustment was more strongly related to aspects of personality, the injury itself, and its treatment.
Since adult burn survivors often develop new symptoms of posttraumatic distress after leaving the hospital, longitudinal surveillance is required to detect new cases and provide appropriate treatment. Survivors at risk for poor psychosocial adjustment after discharge may be identifiable during hospitalization, and preventive treatment strategies should be developed and tested for this population.
本研究旨在调查成年烧伤幸存者创伤后症状的患病率、自然病程及社会心理影响。
使用标准化工具对一家地区烧伤中心的43名成年住院患者在出院时进行评估，以确定是否存在精神障碍、评估人格并量化抑郁程度。31名患者在出院4个月后接受了评估。
出院时7%的患者被诊断为创伤后应激障碍，随访时超过22%的患者被诊断为此病。回避和情感麻木症状（《精神疾病诊断与统计手册》第三版修订版标准C症状）往往在出院后出现。虽然创伤后症状与抑郁症状相关，但与对疾病的社会心理适应并无强烈关联；社会心理适应与人格、损伤本身及其治疗等方面的关系更为密切。
由于成年烧伤幸存者在出院后常出现新的创伤后痛苦症状，因此需要进行纵向监测以发现新病例并提供适当治疗。出院后有社会心理适应不良风险的幸存者在住院期间可能可以被识别出来，应为这一人群制定并测试预防性治疗策略。
