Posttraumatic Stress Disorder and Pain Impact Functioning and Disability After Major Burn Injury
ABSTRACT This study sought to clarify the prospective and concurrent associations of posttraumatic stress disorder (PTSD) and pain with functioning and disability after burn injury. The sample was composed of consecutive patients admitted to a regional burn center with major burn injuries (N = 171) who were followed at 1, 6, 12, and 24 months postdischarge. The predictor measures were the McGill Pain Questionnaire and Davidson Trauma Scale, and the outcome measures were Short Form-36 Health Survey subscales administered at 6, 12, and 24 months after discharge. Linear mixed-effects analyses were conducted to evaluate pain and PTSD as predictors of functional outcomes. Higher PTSD symptom severity soon after hospital discharge was prospectively related to poorer physical and social functioning and greater psychosocial disability (P < .001). However, significant PTSD-by-time interactions also predicted future physical functioning and disability, indicating that the deleterious effects of early PTSD were ameliorated by time. In addition, at each follow-up, PTSD symptoms were concurrently related to greater physical and psychosocial disability, poorer social functioning, and less vitality (P < .001). More severe pain at each follow-up, but not PTSD, was correlated with poorer concurrent physical functioning (P < .002). Significant interaction terms indicated that the concurrent effect of PTSD on psychosocial disability, social functioning, and vitality attenuated during the 24-month recovery period. These findings suggest that assessing PTSD and pain following burn injury may aid in predicting future functioning. Future work should confirm this and evaluate whether aggressively treating both PTSD and pain helps improve functioning after major burn injury.
SourceAvailable from: Paola GremigniRivista di Psichiatria 01/2010; 45(4):221-233. DOI:10.13140/2.1.3525.1849 · 0.28 Impact Factor
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ABSTRACT: Objective The aim of the present study was to evaluate the efficacy of a newly developed cognitive-behavioral group training, specifically designed for burn patients. Method In a multicenter-study data pre- and post treatment and at 6-month follow-up were obtained from participants of the group program (Intervention group, IG; n = 86) and a control group who received treatment as usual (TAU; n = 128). Outcome variables of psychological distress, resources and health-related quality of life of both groups were compared using linear mixed models. Results Up to 6 months after group treatment, the IG reported a substantial decline of general symptom severity as well as posttraumatic stress, whereas the TAU group showed no significant change over time. Optimism increased in the IG after group treatment, but not in the TAU group. Regarding overall quality of life both groups showed a gradual improvement over the three assessment points. Conclusion The newly developed burn-specific cognitive-behavioral group intervention had positive effects on psychological well-being and resources of burn participants. As a consequence, the group intervention has been implemented as inherent part of the regular burn treatment in two rehabilitation centers in Germany.Burns 10/2014; 41(2). DOI:10.1016/j.burns.2014.07.006 · 1.84 Impact Factor
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ABSTRACT: This longitudinal study investigated the temporal relationship patterns between disability and mental health after injury, with a focus on posttraumatic stress disorder (PTSD), depression, and anxiety.Depression and Anxiety 01/2015; 32(1). DOI:10.1002/da.22288 · 4.29 Impact Factor