Department of Psychiatry, Shuang-Ho Hospital, Taipei Medical University, New Taipei City, Taiwan, ROC; School of Post-baccalaureate Medicine, Kaohsiung Medical University, Kaohsiung, Taiwan, ROC.
Department of Medical Research, Tri-Service General Hospital, Taipei, Taiwan, ROC; School of Public Health, National Defense Medical Center, Taipei, Taiwan, ROC.
Burns. 2024 Jun;50(5):1315-1329. doi: 10.1016/j.burns.2024.02.025. Epub 2024 Mar 2.
This investigation identified the association between burn injuries and the risk of mental disorders in patients with no documented pre-existing psychiatric comorbidities. We also examined the relationship of injury severity and the types of injury with the likelihood of receiving new diagnoses of mental disorders.
This population-based retrospective cohort study used administrative data extracted from the Taiwanese National Health Insurance Research Database (NHIRD) between 2000 and 2013. In total, 10,045 burn survivors were matched with a reference cohort of 40,180 patients without burn injuries and were followed to determine if any mental disorder was diagnosed. Patients diagnosed with mental disorders in the five years before study initiation were excluded to ensure incident diagnoses throughout the research duration. Generalized estimating equations in Cox proportional hazard regression models were used for data analysis.
In general, burn injury survivors have a 1.21-fold risk of being diagnosed with new mental disorders relative to patients without burn injuries. Total body surface area (TBSA) of ≧ 30% (aHR: 1.49, 95% CI: 1.36-1.63) and third- or fourth-degree burns (aHR: 1.49, 95% CI: 1.37-1.63) had a significantly greater risk of being diagnosed with mental disorders in comparison to the reference cohort. Patients TBSA 10-29% (aHR: 0.85, 95% CI: 0.77-0.93) and first- or second-degree burn victims (aHR: 0.89, 95% CI: 0.81-0.97) had relatively lower risk of mental disorders than the reference cohort.
Burn injuries were associated with an increased risk of mental disorders. Additional research in this field could elucidate this observation, especially if the inherent limitations of the NHIRD can be overcome.
本研究旨在确定无既往精神疾病病史的烧伤患者发生精神障碍的风险与烧伤之间的关联。我们还研究了损伤严重程度和损伤类型与新发精神障碍诊断可能性之间的关系。
本基于人群的回顾性队列研究使用了 2000 年至 2013 年从台湾全民健康保险研究数据库（NHIRD）中提取的行政数据。共纳入 10045 例烧伤幸存者，并与 40180 例无烧伤的患者进行匹配，以确定是否诊断出任何精神障碍。为了确保在整个研究期间诊断出新发疾病，排除了在研究启动前五年内被诊断为精神障碍的患者。采用广义估计方程 Cox 比例风险回归模型进行数据分析。
总体而言，烧伤幸存者新诊断精神障碍的风险是未烧伤患者的 1.21 倍。与参考队列相比，烧伤总面积（TBSA）≧30%（aHR：1.49，95%CI：1.36-1.63）和三度或四度烧伤（aHR：1.49，95%CI：1.37-1.63）发生精神障碍的风险显著更高。与参考队列相比，TBSA 为 10-29%的患者（aHR：0.85，95%CI：0.77-0.93）和一度或二度烧伤患者（aHR：0.89，95%CI：0.81-0.97）发生精神障碍的风险相对较低。
烧伤与精神障碍的风险增加有关。如果能够克服 NHIRD 的固有局限性，对该领域的进一步研究可能会阐明这一观察结果。
