PREINJURY PSYCHIATRIC-ILLNESS AND POSTINJURY ADJUSTMENT IN ADULT BURNSURVIVORS

The impact of preinjury DSM-III-R anxiety, mood, and alcohol and subst ance abuse disorders, determined by using the Structured Clinical Inte rview for DSM-III-R, nonpatient version (SCID-NP), on postinjury adjus tment was examined prospectively in a consecutive series of 98 adult p atients admitted to a regional burn center and followed for 1 year. Th e subjects were grouped according to SCID diagnoses: 1) any preburn mo od and/or anxiety diagnosis; 2) preburn alcohol abuse or dependence di agnosis; or 3) any preburn diagnosis (i. e., any of the above diagnose s). These groups showed greater impairment in many functional domains at discharge than the subjects who had no preburn disorder By 4 months postinjury, the ''no diagnosis'' and the preburn diagnosis groups had comparable levels of adjustment, and this comparability was maintaine d at the 1-year follow-up. Similarly, trait neuroticism had an early n egative impact on adjustment, while trait extroversion had both an ear ly and late positive effect on adjustment.