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Prevalence of Major Psychiatric Illness in Young Adults Who Were Burned as Children

From Shriners Hospital for Children (W.J.M., P.B., C.R.T., R.S.R.), Shriners Burns Hospital, Galveston, TX; the Department of Psychiatry and Behavioral Science (W.J.M., C.R.T., W.R.), and the Department of Surgery (P.B., R.S.R.), University of Texas Medical Branch, Galveston, TX.

Address correspondence and reprint requests to Walter J. Meyer, III, Department of Psychiatry and Behavioral Science, University of Texas Medical Branch, 301 University Blvd. Galveston, TX 77555-0189. E-mail: wmeyer{at}utmb.edu

Objective: To determine the prevalence of major psychiatric illness in a group of young adults who suffered significant burn injury as children.

Method: A total of 101 persons (58 males, 43 females), aged 21 ± 2.6 years, 14.0 ± 5.4 years postburn of 54% ± 20% total body surface area, were assessed for serious past and present mental illness by using a Structured Clinical Interview (SCID) for Diagnostic and Statistical Manual of Mental Disorders, 4th Edition (DSM-IV) Axis I diagnoses.

Results: The SCID findings demonstrated that the prevalence of any Axis I major mental illness was 45.5% for the past month (current) and 59.4% for lifetime. These rates of overall disorder and the rates for most specific disorders were significantly higher than those found in the US population of comparable age. Logistic regression was used to examine demographic and burn characteristics as predictors of current and lifetime psychiatric disorder within the burn survivor sample. The female gender was significantly associated with higher rates of any current disorder. Other demographic and burn characteristics were not significantly related to the overall prevalence of current or lifetime disorder. Only a small number of those with disorders reported any current mental health treatment.

Conclusions: Significant burn injury as a child leads to an increased risk of developing a major mental illness. Young adults who suffered major burn injury as children should be screened for these illnesses to initiate appropriate treatment.

Key Words: burn injury • anxiety disorders • depression • alcohol • substance dependence • Structured Clinical Interview

Abbreviations: TBSA = total body surface area; SCID = Structured Clinical Interview; NCS = National Comorbidity Survey; DIS = Diagnostic Interview Schedule; CIDI = Composite International Diagnostic Interview; PTSD = posttraumatic stress disorder.