Demographic and clinical characteristics of patients with burns referred for psychiatric assessment to a tertiary care hospital in Sri Lanka

Introduction Burns cause significant psychological morbidity. The relationship between burns and psychiatric conditions is bidirectional. There are no Sri Lankan studies describing psychological morbidity among adults with burns. Objectives To describe the psychological morbidity and associated factors in patients with burn injuries referred to the University Psychiatry Unit, National Hospital of Sri Lanka. Methods A descriptive cross-sectional study was carried out by extracting demographic and clinical data from records of all patients with burns referred for psychiatric assessment for two years from 1st January 2018 to University Psychiatry Unit. Associations were explored using chi-square test. A p value of ≤ 0.05 was taken as significant. Results Eighty-seven records were analysed: 56.3% were females. Mean age was 37.8 years (SD=15.8). Mean burn surface area was 36.2% (SD=16.6). Cause of burn was accidental in 61.5%, self-inflicted in 34.6% and homicidal in 3.9%. In 27 with self-inflicted burns, 12 reported less than 30-minute contemplation of act, 24 a preceding conflict and 18 intention to frighten another. Past diagnosis of mental illness was detected in 38.3% (p=0.046, 95% CI 27.7-47.7), substance use in12.2%), and personality disorders in 11%. Psychiatric morbidity after burn injury was detected in 64.2% (p=0.015, 95% CI 52.8-74.6), most frequent being depressive disorder (35.5%) followed by adjustment disorder (17.7%) and delirium (7.6%). Female gender, age <30 years and history of psychiatric illness were significantly associated with self-inflicted burns. No demographic or clinical factors had significant association with psychiatric morbidity. Conclusion There is significant psychological morbidity after burn injuries.