Psychiatric assessment of burned children and adolescents followed in a training and research hospital’s burns unit

Objective: Burn is a trauma affecting many systems in the human body that may cause temporary or permanent morbidity. Some emotional or social problems are also observed beside physical disorders in burned children or adolescents. This study was aimed to evaluate the psychiatric status of hospitalized children in a burns unit retrospectively.

Method: Data of burned children, hospitalized in the Ankara Pediatric Hematology Oncology Training and Research Hospital between June 2013 and August 2014, who were seen by the Child Psychiatry Department, were evaluated. A total of 19 children’s data were collected, including demographic features, reasons for consultation, their medical as well as psychiatric evaluation and treatment. All variables were analyzed by using SPSS 17.0 (Chicago Inc., 2008) program.

Results: Mean age of cases was 103.6±61.8 months (24-210 months), 68.4% of them (n=13) were male and 31.6% of them were female. The most common cause of burn was accidents (n=15, 78.9%). Burns had arisen from open fire (n=7, 36.8%), liquids like hot water or milk (n=6, 31.6%). The mean percentage of total body surface area burned was 41.7% (11-70% range), and the majority of cases had second and/or third-degree burns (n=11, 57.9%). Mean duration of hospitalization in the burns unit was 42.8±34.1 days (13-128 days). Mean day of psychiatric consultation after hospitalization was 20 (7-52 days) and the mean number of consultations was two (1-5) for all children. “Sleep problems” was the most common reason for consultation (n=8, 42.1%). Psychiatric evaluation in the first examination resulted as follows: 36.8% (n=7) had “acute stress disorder”, 26.3% (n=5) “normal adaptation process”, 15.8% (n=3) showed “anxiety disorders”, 15.8% (n=3) had “adjustment disorder”. It was found that after first psychiatric consultation 42.1% of the patients (n=8) were not recommended any medication. Selective serotonin reuptake inhibitor (SSRI) (36.8%, n=7), hydroxyzine hydrochloride (10.5%, n=2), benzodiazepine (5.3%, n=1) and risperidone (5.3%, n=1) were prescribed in this population.

Conclusion: The determination of psychopathology in most children with burns and the finding of “acute stress disorder” as the most common psychopathology in these patients are consistent with the literature. There are few studies regarding treatment of stress emerging after trauma in children. Recognizing early symptoms of these patients is crucial for early psychiatric evaluation and intervention to reduce development of psychiatric comorbidity. There is a need for further studies about pharmacotherapy in pediatric burns patients.