Fauerbach J A, Lawrence J, Stevens S, Munster A
Johns Hopkins Bayview Medical Center, and the Johns Hopkins University School of Medicine, Baltimore, Maryland 21224, USA.
J Burn Care Rehabil. 1998 May-Jun;19(3):247-52.
Participants (n=95) were assessed at the time of discharge and at 4 and 12 months after discharge in regard to work status and psychiatric history both before and after the burn injury. Complex psychiatric comorbidity and substance abuse disorders that occurred before the burn injury each significantly raised the risk of unemployment before the burn injury; preburn substance abuse also affected unemployment at 4 months after the burn injury. Trends for higher unemployment rates at 12 months after discharge also were noted among those with a preburn history of complex psychiatric comorbidity and alcohol use, anxiety, or mood disorder. Preburn substance-use disorder raised the risk of attrition from the 12-month study; whereas, those diagnosed at the time of discharge with post-traumatic stress disorder or with two or more current psychiatric disorders after the burn injury dropped out less often. The greater risk for unemployment and attrition observed among subjects with psychiatric disorders before the burn injury suggests the need for routine screening, tracking, and assistance in accessing supportive or rehabilitative services to remove barriers to employment.
研究对象（n = 95）在出院时、出院后4个月和12个月时接受了评估，内容涉及烧伤前后的工作状况和精神病史。烧伤前发生的复杂精神共病和物质使用障碍均显著增加了烧伤前失业的风险；烧伤前的物质使用障碍也影响了烧伤后4个月时的失业情况。在有烧伤前复杂精神共病及酒精使用、焦虑或情绪障碍病史的患者中，也观察到出院后12个月时失业率较高的趋势。烧伤前物质使用障碍增加了12个月研究期内失访的风险；而在出院时被诊断为创伤后应激障碍或烧伤后患有两种或更多种当前精神障碍的患者中，失访的情况较少。烧伤前患有精神障碍的受试者中观察到的更高失业风险和失访风险表明，需要进行常规筛查、跟踪，并协助他们获得支持性或康复服务，以消除就业障碍。
