Background: Major burns that require hospitalizations pose psychiatric impacts on burn survivors which are associated with poor outcomes Studies on the risk of psychiatric disorders after burns have observed a large discrepancy most likely because of different methodologies and limited sample sizes Objective: The aim of this study was to evaluate the risk of various psychiatric disorders after burns using a population-based study in Taiwan Methods: This retrospective cohort study used Taiwan National Health Insurance Research Database The burn cohort included hospitalized individuals with burns diagnosed between 2000 and 2012 and the comparison cohort included hospitalized individuals for appendectomies We excluded individuals who had any pre-existing psychiatric disorder before they had a diagnosis of burn or appendectomy We traced each individual in the two cohorts for a one-year period and identified psychiatric disorders using insurance claims Cox proportional hazards regression models were used to compare the risk of psychiatric disorders between the two cohorts Results: The burn cohort consisted of 2 231 individuals and the comparison cohort consisted of 7 408 individuals The incidences of many psychiatric disorders were higher in the burn cohort than in the comparison cohort including adjustment disorders neurotic disorders bipolar disorders depressive disorders sleep disorders substance related disorders and personality disorders After adjusting the covariates the burn cohort had higher risks of adjustment disorders (adjusted hazard ratio [AHR]: 4 75; 95% confidence interval [CI]: 1 26-17 92) depressive disorders (AHR: 9 91; 95% CI: 5 28-18 58) and substance related disorders (AHR: 3 36; 95% CI: 1 52-7 45) Diabetes mellitus cancer and more extensive of burned surface area were significant factors associated with developing psychiatric disorders after burns Conclusions: Major burns were associated with increased risks of adjustment disorders depressive disorders and substance related disorders during the one-year period after the incident Therapeutic strategy for burn survivors should include surveillance and treatment of psychiatric disorders with an emphasis on those identified in this study to achieve a complete recovery
Date of Award | 2017 Aug 16 |
---|
Original language | English |
---|
Supervisor | How-Ran Guo (Supervisor) |
---|
Psychiatric sequelae after burns in Taiwan
婉吟, 郭. (Author). 2017 Aug 16
Student thesis: Master's Thesis