Department of Psychiatry and Behavioral Sciences, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA.
Department of Plastic and Reconstructive Surgery, Division of Burn Surgery, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA.
J Burn Care Res. 2021 May 7;42(3):357-364. doi: 10.1093/jbcr/irab014.
Burn survivors may be at increased risk for suicide due to the nature of their injury and psychiatric comorbidities. The purpose of this review is to assess the evidence as to the prevalence of suicidal ideations and behaviors (attempts and completed suicides) in burn survivors as well as evaluate risk and protective factors. PubMed, EMBASE, CINAHL, Cochrane, PsycINFO, and Web Science databases were searched using search terms regarding suicide, suicidality, and burn. Fourteen full-text manuscripts and two published abstracts were included in the review. Overall, burn survivors demonstrate elevated suicidal ideations and a higher lifetime prevalence of suicide attempts compared to the general population. There is mixed evidence as to rates of completed suicide postburn injury, though rates appear to be relatively low. Risk factors include pain at discharge, perceived level of disfigurement, premorbid psychiatric comorbidities, and past suicide attempts. Results of this systematic review shed light on the scarcity of data on rates of suicidality among burn survivors, which is surprising given the multiple risk factors burn survivors possess including chronic pain, sleep disturbances, history of substance abuse, posttraumatic stress disorder, social isolation, and depression which are linked to suicidality in the general population. Suicide risk screening should be included as an integral part of burn survivors' care, and more research is needed to better understand the magnitude of this phenomenon and offer targeted interventions to vulnerable individuals.
烧伤幸存者由于其受伤的性质和精神共病，可能面临更高的自杀风险。本综述的目的是评估烧伤幸存者中自杀意念和行为（尝试和完成自杀）的流行程度的证据，并评估风险和保护因素。使用关于自杀、自杀意念和烧伤的搜索词，在 PubMed、EMBASE、CINAHL、Cochrane、PsycINFO 和 Web Science 数据库中进行了搜索。综述共纳入了 14 篇全文文献和 2 篇已发表的摘要。总体而言，与普通人群相比，烧伤幸存者表现出更高的自杀意念和更高的终生自杀尝试率。关于烧伤后自杀的完成率，证据不一，但似乎相对较低。风险因素包括出院时的疼痛、感知的毁容程度、先前的精神共病和既往自杀尝试。本系统综述的结果揭示了有关烧伤幸存者自杀意念率的数据稀缺的问题，这令人惊讶，因为烧伤幸存者存在多种风险因素，包括慢性疼痛、睡眠障碍、物质滥用史、创伤后应激障碍、社会隔离和抑郁，这些因素与普通人群中的自杀意念有关。应将自杀风险筛查作为烧伤幸存者护理的一个组成部分，需要进行更多的研究，以更好地了解这一现象的严重程度，并为易受伤害的个体提供有针对性的干预措施。
