急性烧伤患者的精神障碍。

Mental disorders among acute burn patients.

机构信息

Department of Psychiatry, Helsinki University Central Hospital, Helsinki, Finland.

出版信息

Burns. 2010 Nov;36(7):1072-9. doi: 10.1016/j.burns.2010.04.004. Epub 2010 May 18.

DOI:10.1016/j.burns.2010.04.004

PMID:20483541

Abstract

OBJECTIVE

To investigate mental disorders among acute hospitalized burn patients.

METHOD

Consecutive acute adult burn patients (n=107) admitted to Helsinki Burn Centre were interviewed by an experienced psychiatrist with the Structured Clinical Interview for DSM-IV-TR for Axis I and II mental disorders assessed in three time frames (lifetime, the month prior to burn, and in acute care). Information on clinical features, psychiatric symptoms, personality traits, and burn severity (total body surface area, TBSA) was gathered.

RESULTS

The mean TBSA was 9%. Most (61%) acute burn patients had at least one lifetime Axis I or II mental disorder. Prevalences of lifetime substance-related disorders (47%), psychotic disorders (10%), and Axis II personality disorders (23%) were high. The overall prevalence of Axis I mental disorders increased significantly (Q=6.40, df=1, p=0.011) from the month prior to burn (40%) to acute care (48%). The prevalence of delirium for this period was significantly higher (0.9% vs. 13%; Q=13.00, df=1, p<0.001) in acute care.

CONCLUSIONS

Mental disorders, particularly substance use disorders, psychotic disorders, and personality disorders are common among acute burn patients before injury. These disorders may predispose to burns. Burn itself may also predispose to mental disorders, particularly delirium.

摘要

目的

调查急性住院烧伤患者的精神障碍情况。

方法

采用 DSM-IV-TR 轴 I 和轴 II 定式临床访谈对连续入住赫尔辛基烧伤中心的 107 例成年急性烧伤患者（n=107）进行访谈，评估其在三个时间点（终生、烧伤前 1 个月和急性照护期间）的精神障碍。收集了临床特征、精神症状、人格特质和烧伤严重程度（总体表面积，TBSA）等信息。

结果

平均 TBSA 为 9%。大多数（61%）急性烧伤患者至少有一种终生轴 I 或轴 II 精神障碍。终生物质相关障碍（47%）、精神病性障碍（10%）和轴 II 人格障碍（23%）的患病率较高。从烧伤前 1 个月（40%）到急性照护期间（48%），轴 I 精神障碍的总体患病率显著增加（Q=6.40，df=1，p=0.011）。在此期间，谵妄的患病率显著更高（0.9%比 13%；Q=13.00，df=1，p<0.001）。