Burn Patients Need More Help Coping With Depression

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A new study reveals the full extent of psychological problems among people who have spent years recovering from serious burns. About half of those surveyed showed signs of clinical depression, with women being most vulnerable.

While the study findings may not be surprising, specialists are calling them a valuable tool that could spur burn centers to devote more resources to mental healing.

"In addition to looking at whether we can fix this or alter that through plastic surgery, we also need to screen people for depression,” said lead author Brett Thombs, who worked on the study at Johns Hopkins University. He now serves as an assistant professor of psychiatry at McGill University in Canada.

Thomas and colleagues surveyed 224 Johns Hopkins patients who were undergoing reconstruction surgery after being burned. On average, the patients suffered burns about seven years earlier.

The findings appear in the January/February issue of the journal General Hospital Psychiatry.

Forty-six percent of those surveyed showed signs of mild, moderate or serious depression. Women and those most concerned about their body images were most likely to be depressed.

It’s normal for burn victims to have trouble adjusting to their condition, Thombs said. “I don’t think anyone would go through a burn without being horribly sad. It’s a very tough adjustment to make.”

But some remain depressed and don’t recover, failing to move “through a course of grief and be able to pick themselves up and find their way on their own,” he said. “They need help of some kind.”

There are effective ways to help burn victims who feel ostracized, said Leora Bowden, a clinical social worker who works with burn patients at the University of Michigan. With the help of treatments like cognitive therapy — aimed at changing thought patterns — patients can “improve their ability to function and their ability to feel better about themselves, both of which are equally important,” she said.

It isn’t possible to change society’s reaction to disfigured people, said John Findley, psychiatrist for the burn and trauma unit at Massachusetts General Hospital. “But we can get (patients) to look at themselves differently, look beyond the skin and see the healthy person that was there before the thermal injury.”

General Hospital Psychiatry is a peer-reviewed research journal published bimonthly by Elsevier Science. For information about the journal, contact Wayne Katon, M.D., at (206) 543-7177.

Thombs BD, et al. “Depression in Burn Reconstruction Patients: Symptom Prevalence and Association With Body Image Dissatisfaction and Physical Function. General Hospital Psychiatry 29(1) 2007.

Source: Health Behavior News Service

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