Impact of personality disorders on health-related quality of life one year after burn injury

• Published in: Disability and rehabilitation 2015-01, Vol.37 (6), p.534-540
• Main Authors: Ekeblad, Frida, Gerdin, Bengt, Öster, Caisa
• Format: Article
• Language: English
• Subjects: Adult; Aged; Aged, 80 and over; Burn injury; Burns - psychology; Burns - rehabilitation; Female; Health Status; Health Surveys; health-related quality of life; Humans; Longitudinal Studies; Male; Middle Aged; outcome measure; personality disorder; Personality Disorders - complications; Prospective Studies; Quality of Life; Regression Analysis; Surveys and Questionnaires; Young Adult
• ISSN: 0963-8288; 1464-5165; 1464-5165
• DOI: 10.3109/09638288.2014.933898

Abstract Purpose: Personality disorders (PDs) are associated with significant distress, disability, and cause great difficulties in life. PDs have been suggested to influence adaptation after major burns, but the potential relationship has not been fully elucidated. This study aimed to describe the prevalence of PDs in 107 patients with major burn injury, and to identify the impact of PDs on perceived patient outcome assessed as health-related quality of life (HRQoL) one year after burn. Methods: One burn-specific instrument (Burn Specific Health Scale-Brief (BSHS-B)) and two generic instruments (EuroQol Five Dimensions and Short Form 36 Health Survey) were used, and Psychiatric Axis I and II disorders were assessed one year post burn. Results: This study identified an above normal prevalence of PDs among individuals afflicted by burn, and participants with PD had a significantly larger lifetime burden of Axis I disorders compared to participants without PD. Participants with PDs scored significantly lower than those without PD in the BSHS-B domain Skin involvement, and the effect of having a PD was related to the subscale Treatment regimens. There was no relationship between the presence of PD and generic HRQoL. Conclusions: An implication of these observations is that special rehabilitation efforts including more tailored interventions must be offered to these patients to ensure that the obstacles they perceive to caring for themselves in this respect are eliminated.Implications for RehabilitationThis study identified an above normal prevalence of PDs among individuals afflicted by burn and these individuals reported poor burn-specific health-related quality of life.The identification of difficulties with compliance and endurance regarding daily skin care may cause negative consequences for optimal rehabilitation and underscore the importance of offering more tailored interventions in rehabilitation.Inflexible behavioral patterns related to the PD diagnosis imply the need for communication strategies by the rehabilitation team, which include flexibility, creativity, and diplomacy.There is a need for further research focusing on identifying the factors that facilitate the individual's own ability to take action and have control.