A population-based comparison study of the mental health of patients with intentional and unintentional burns

Thirthar P. Vetrichevvel, Sean M. Randall, Fiona M. Wood, Suzanne Rea, James H. Boyd, Janine M. Duke

Research output: Contribution to journalArticle

Abstract

BackgroundA number of studies report high prevalence of mental health conditions among burn patients. However there is a need to understand differences in the temporal relationship between mental health conditions and intentional and unintentional burns to hasten psychological prevention and intervention. This studyaims to compare the socio-demographic profile, burn characteristics and pre- and post-burn psychiatric morbidity of burn patients by intent-of-injury.MethodsDe-identified linked hospital, death and mental health (MH) case registry data of burn patients hospitalised in Western Australia between 1 January 1980 and 30 June 2012 were analysed. Crude (observed) post-burn rates of mental health admissions were generated by burn intent-of-injury. Descriptive statistics were performed to compare the characteristics of the burn patients.ResultsA total of 30,997 individuals were hospitalised for a first burn; 360 (1.2%) had self-harm burns and 206 (0.7%) assault burns. Over the study period, admission rates for assault burns increased by 4.8% per year (95% confidence interval (CI) 3.1-6.5%) and self-harm burns increased 6.9% per year (95% CI 4.8-9.1%). Self-harm and assault burns occurred mainly among those aged 15 to 44years (median age, interquartile range (IQR): self-harm 30years, 22-40; assault 31years, 23-38). Those with self-harm burns had a longer index hospital stay (median (IQR): self-harm 15days (5-35) vs 4days (1-11) assault vs 4days (1-10) unintentional) and higher in-hospital mortality (7.2% self-harm vs 1.9% assault burns vs 0.8% unintentional). More than half (55.0%) of self-harm burns had a prior hospitalisation (5-year lookback) for a MH condition vs 10.7% of assault burns and 2.8% of unintentional burns. Crude post-burn rates of MH admissions per 100 person-years (PY) by intent-of-burn subgroups: self-harm 209 per 100 PY, assault burns 11 per 100 PY and unintentional burns 3 per 100 PY.ConclusionsIntentional burn patients experienced significantly higher pre- and post-burn mental health morbidity along with significant adverse outcome in comparison with unintentional burns. Early psychological assessment and intervention could help in improving the MH of these patients.

Original languageEnglish
Number of pages10
JournalBurns & Trauma
Volume6
DOIs
Publication statusPublished - 6 Nov 2018

Cite this

@article{dede031e06b44f719b7627dc81b6fc61,
title = "A population-based comparison study of the mental health of patients with intentional and unintentional burns",
abstract = "BackgroundA number of studies report high prevalence of mental health conditions among burn patients. However there is a need to understand differences in the temporal relationship between mental health conditions and intentional and unintentional burns to hasten psychological prevention and intervention. This studyaims to compare the socio-demographic profile, burn characteristics and pre- and post-burn psychiatric morbidity of burn patients by intent-of-injury.MethodsDe-identified linked hospital, death and mental health (MH) case registry data of burn patients hospitalised in Western Australia between 1 January 1980 and 30 June 2012 were analysed. Crude (observed) post-burn rates of mental health admissions were generated by burn intent-of-injury. Descriptive statistics were performed to compare the characteristics of the burn patients.ResultsA total of 30,997 individuals were hospitalised for a first burn; 360 (1.2{\%}) had self-harm burns and 206 (0.7{\%}) assault burns. Over the study period, admission rates for assault burns increased by 4.8{\%} per year (95{\%} confidence interval (CI) 3.1-6.5{\%}) and self-harm burns increased 6.9{\%} per year (95{\%} CI 4.8-9.1{\%}). Self-harm and assault burns occurred mainly among those aged 15 to 44years (median age, interquartile range (IQR): self-harm 30years, 22-40; assault 31years, 23-38). Those with self-harm burns had a longer index hospital stay (median (IQR): self-harm 15days (5-35) vs 4days (1-11) assault vs 4days (1-10) unintentional) and higher in-hospital mortality (7.2{\%} self-harm vs 1.9{\%} assault burns vs 0.8{\%} unintentional). More than half (55.0{\%}) of self-harm burns had a prior hospitalisation (5-year lookback) for a MH condition vs 10.7{\%} of assault burns and 2.8{\%} of unintentional burns. Crude post-burn rates of MH admissions per 100 person-years (PY) by intent-of-burn subgroups: self-harm 209 per 100 PY, assault burns 11 per 100 PY and unintentional burns 3 per 100 PY.ConclusionsIntentional burn patients experienced significantly higher pre- and post-burn mental health morbidity along with significant adverse outcome in comparison with unintentional burns. Early psychological assessment and intervention could help in improving the MH of these patients.",
keywords = "Intentional burns, Mental health, Self-harm burns, Assault burns, Epidemiology, SELF-INFLICTED BURNS, LONG-TERM MORTALITY, WESTERN-AUSTRALIA, CYTOKINE ALTERATIONS, INJURY, EPIDEMIOLOGY, ADULTS, MORBIDITY, ASSAULT, COHORT",
author = "Vetrichevvel, {Thirthar P.} and Randall, {Sean M.} and Wood, {Fiona M.} and Suzanne Rea and Boyd, {James H.} and Duke, {Janine M.}",
year = "2018",
month = "11",
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doi = "10.1186/s41038-018-0133-0",
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A population-based comparison study of the mental health of patients with intentional and unintentional burns. / Vetrichevvel, Thirthar P.; Randall, Sean M.; Wood, Fiona M.; Rea, Suzanne; Boyd, James H.; Duke, Janine M.

In: Burns & Trauma, Vol. 6, 06.11.2018.

Research output: Contribution to journalArticle

TY - JOUR

T1 - A population-based comparison study of the mental health of patients with intentional and unintentional burns

AU - Vetrichevvel, Thirthar P.

AU - Randall, Sean M.

AU - Wood, Fiona M.

AU - Rea, Suzanne

AU - Boyd, James H.

AU - Duke, Janine M.

PY - 2018/11/6

Y1 - 2018/11/6

N2 - BackgroundA number of studies report high prevalence of mental health conditions among burn patients. However there is a need to understand differences in the temporal relationship between mental health conditions and intentional and unintentional burns to hasten psychological prevention and intervention. This studyaims to compare the socio-demographic profile, burn characteristics and pre- and post-burn psychiatric morbidity of burn patients by intent-of-injury.MethodsDe-identified linked hospital, death and mental health (MH) case registry data of burn patients hospitalised in Western Australia between 1 January 1980 and 30 June 2012 were analysed. Crude (observed) post-burn rates of mental health admissions were generated by burn intent-of-injury. Descriptive statistics were performed to compare the characteristics of the burn patients.ResultsA total of 30,997 individuals were hospitalised for a first burn; 360 (1.2%) had self-harm burns and 206 (0.7%) assault burns. Over the study period, admission rates for assault burns increased by 4.8% per year (95% confidence interval (CI) 3.1-6.5%) and self-harm burns increased 6.9% per year (95% CI 4.8-9.1%). Self-harm and assault burns occurred mainly among those aged 15 to 44years (median age, interquartile range (IQR): self-harm 30years, 22-40; assault 31years, 23-38). Those with self-harm burns had a longer index hospital stay (median (IQR): self-harm 15days (5-35) vs 4days (1-11) assault vs 4days (1-10) unintentional) and higher in-hospital mortality (7.2% self-harm vs 1.9% assault burns vs 0.8% unintentional). More than half (55.0%) of self-harm burns had a prior hospitalisation (5-year lookback) for a MH condition vs 10.7% of assault burns and 2.8% of unintentional burns. Crude post-burn rates of MH admissions per 100 person-years (PY) by intent-of-burn subgroups: self-harm 209 per 100 PY, assault burns 11 per 100 PY and unintentional burns 3 per 100 PY.ConclusionsIntentional burn patients experienced significantly higher pre- and post-burn mental health morbidity along with significant adverse outcome in comparison with unintentional burns. Early psychological assessment and intervention could help in improving the MH of these patients.

AB - BackgroundA number of studies report high prevalence of mental health conditions among burn patients. However there is a need to understand differences in the temporal relationship between mental health conditions and intentional and unintentional burns to hasten psychological prevention and intervention. This studyaims to compare the socio-demographic profile, burn characteristics and pre- and post-burn psychiatric morbidity of burn patients by intent-of-injury.MethodsDe-identified linked hospital, death and mental health (MH) case registry data of burn patients hospitalised in Western Australia between 1 January 1980 and 30 June 2012 were analysed. Crude (observed) post-burn rates of mental health admissions were generated by burn intent-of-injury. Descriptive statistics were performed to compare the characteristics of the burn patients.ResultsA total of 30,997 individuals were hospitalised for a first burn; 360 (1.2%) had self-harm burns and 206 (0.7%) assault burns. Over the study period, admission rates for assault burns increased by 4.8% per year (95% confidence interval (CI) 3.1-6.5%) and self-harm burns increased 6.9% per year (95% CI 4.8-9.1%). Self-harm and assault burns occurred mainly among those aged 15 to 44years (median age, interquartile range (IQR): self-harm 30years, 22-40; assault 31years, 23-38). Those with self-harm burns had a longer index hospital stay (median (IQR): self-harm 15days (5-35) vs 4days (1-11) assault vs 4days (1-10) unintentional) and higher in-hospital mortality (7.2% self-harm vs 1.9% assault burns vs 0.8% unintentional). More than half (55.0%) of self-harm burns had a prior hospitalisation (5-year lookback) for a MH condition vs 10.7% of assault burns and 2.8% of unintentional burns. Crude post-burn rates of MH admissions per 100 person-years (PY) by intent-of-burn subgroups: self-harm 209 per 100 PY, assault burns 11 per 100 PY and unintentional burns 3 per 100 PY.ConclusionsIntentional burn patients experienced significantly higher pre- and post-burn mental health morbidity along with significant adverse outcome in comparison with unintentional burns. Early psychological assessment and intervention could help in improving the MH of these patients.

KW - Intentional burns

KW - Mental health

KW - Self-harm burns

KW - Assault burns

KW - Epidemiology

KW - SELF-INFLICTED BURNS

KW - LONG-TERM MORTALITY

KW - WESTERN-AUSTRALIA

KW - CYTOKINE ALTERATIONS

KW - INJURY

KW - EPIDEMIOLOGY

KW - ADULTS

KW - MORBIDITY

KW - ASSAULT

KW - COHORT

U2 - 10.1186/s41038-018-0133-0

DO - 10.1186/s41038-018-0133-0

M3 - Article

VL - 6

JO - Burns & Trauma

JF - Burns & Trauma

SN - 2321-3876

ER -