Psychological distress after major burn injury

James A. Fauerbach, Jodi McKibben, O. Joseph Bienvenu, Gina Magyar-Russell, Michael T. Smith, Radha Holavanahalli, David R. Patterson, Shelley A. Wiechman, Patricia Blakeney, Dennis Lezotte

Research output: Contribution to journalArticlepeer-review

81 Scopus citations


OBJECTIVE: To track the prevalence and stability of clinically significant psychological distress and to identify potentially modifiable inhospital symptoms predictive of long-term distress (physical, psychological, and social impairment). METHOD: We obtained data from the Burn Model Systems project, a prospective, multisite, cohort study of major burn injury survivors. The Brief Symptom Inventory (BSI) was used to assess symptoms in-hospital (n = 1232) and at 6 (n = 790), 12 (n = 645), and 24 (n = 433) months post burn. Distress was examined dimensionally (BSI's Global Severity Index (GSI)) and categorically (groups formed by dichotomizing GSI: T score ≥63). Attrition was unrelated to in-hospital GSI score. RESULTS: Significant in-hospital psychological distress occurred in 34% of the patients, and clinically significant and reliable change in symptom severity by follow-up visits occurred infrequently. Principal components analysis of in-hospital distress symptoms demonstrated "alienation" and "anxiety" factors that robustly predicted distress at 6, 12, and 24 months, controlling for correlates of baseline distress. CONCLUSIONS: This is the largest prospective, multisite, cohort study of patients with major burn injury. We found that clinically significant in-hospital psychological distress was common and tends to persist. Two structural components of in-hospital distress seemed particularly predictive of long-term distress. Research is needed to determine if early recognition and treatment of patients with in-hospital psychological distress can improve long-term outcomes.

Original languageEnglish (US)
Pages (from-to)473-482
Number of pages10
JournalPsychosomatic medicine
Issue number5
StatePublished - Jun 2007


  • Burn injury
  • Burn model systems
  • Predictors
  • Prevalence
  • Prospective
  • Psychological distress

ASJC Scopus subject areas

  • Applied Psychology
  • Psychiatry and Mental health


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