Neuropsychiatric Complications in Burn Patients

Abstract

The neuropsychiatric problems which burn patients experience may occur either during hospitalization or after discharge. Some of these may be considered “normal” in that they occur in many patients and are not pathological or life-threatening if handled appropriately. Others tend to interfere with the recovery process and are associated with a poor prognosis. Normal reactions which occur during hospitalization include anxiety reaction, mild depression, fear of deformity, and a steadily decreasing pain threshold. Potentially pathological reactions during hospitalization, which occur in 20 to 30 per cent of all patients, include severe depression, severe regression, and delirium. After discharge most patients, especially those with severe burns, face further adjustment problems. Follow-up study indicates that during the first year many patients continue to have symptoms of depression, anxiety, and phobic behavior. Most patients who have a normal adjustment prior to injury, however, eventually learn to deal with these problems without psychiatric help. The psychiatric prognosis for children is somewhat poorer, however, with approximately 80 per cent showing complications and sequelae such as fearfulness, suspiciousness, poor school performance, and difficulty in relating to other children.