Predictors of post-traumatic stress disorder among burn patients in Pakistan: The role of reconstructive surgery in post-burn psychosocial adjustment

• Published in: Burns 2018-05, Vol.44 (3), p.620-625
• Main Authors: Waqas, Ahmed, Raza, Nahal, Zahid, Termina, Rehman, Abdul, Hamid, Tooba, Hanif, Ayesha, Jamal, Mehak, Farrukh, Ayesha, Azam, Abeera, Turk, Marvee, Chaudhry, Muhammad Ashraf
• Format: Article
• Language: English
• Subjects: Body Surface Area; Burns; Burns - psychology; Burns - surgery; Cross-Sectional Studies; Domestic Violence - psychology; Domestic Violence - statistics & numerical data; Educational Status; Emotional Adjustment; Ethnic Groups - psychology; Ethnic Groups - statistics & numerical data; Female; Humans; Male; Minority Groups - psychology; Minority Groups - statistics & numerical data; Multivariate Analysis; Pakistan; Pakistan - epidemiology; Post-traumatic stress disorder; Prevalence; Reconstructive Surgical Procedures; Regression Analysis; Resilience, Psychological; Risk Factors; Social Adjustment; Social Support; Stress Disorders, Post-Traumatic - epidemiology; Stress Disorders, Post-Traumatic - psychology; Suicidal Ideation; Trauma Severity Indices; Unemployment - psychology; Unemployment - statistics & numerical data
• ISSN: 0305-4179; 1879-1409
• DOI: 10.1016/j.burns.2017.09.012

•We demonstrate an alarmingly high prevalence of PTSD (69.1%) among patients presenting with burns in Pakistan.•Lower educational attainment, ethnic minority status, unemployment, increased burn surface area, prior suicidal ideation, and domestic violence were all associated with increased PTSD symptomatology.•Adequate social support, high ego resiliency, and reconstructive surgery were all associated with decreased PTSD symptomatology. Burns are a common cause of morbidity and mortality worldwide. Post-traumatic stress disorder (PTSD) is among the most prevalent psychopathologies documented among burn patients. However, little is known regarding the risk factors for post-burn PTSD outside the well-documented Western world context. The present study aims to elucidate the biopsychosocial correlates of PTSD among burn patients in Pakistan. A total 343 burn patients were evaluated across four teaching hospitals in the Punjab province of Pakistan between August and December of 2016. “Patients aged 18 years or older, with no major comorbid illnesses, presenting for burn care at burn units or surgical departments of the listed hospitals were interviewed by trained healthcare providers using a validated questionnaire.” Uni- and multivariate statistical analyses were used to evaluate associations between patient characteristics and PTSD symptomatology, as measured by the validated Urdu version of the Impact of Event Scale-Revised (IES-R). The prevalence of PTSD among our cohort was 69%. Lower educational attainment, ethnic minority status, unemployment, large burn surface area, prior suicidal ideation, and domestic violence were all associated with increased PTSD symptomatology. On the other hand, social support, ego resiliency, and reconstructive surgery were all associated with decreased PTSD symptomatology. There is a remarkably high prevalence of PTSD among burn patients in Pakistan. Improving accessibility to reconstructive surgery and social support may help to alleviate this burden.