PREBURN PSYCHIATRIC HISTORY AFFECTS POSTTRAUMA MORBIDITY

A sample of inpatient, burn-injured adults (N = 95) were assessed upon discharge, and 4 and 12 months later with a structured interview and DSM-III-R criteria. The prevalence of disorder in this sample was cont rasted with published data on a representative national community-dwel ling comparison group in the National Comorbidity Study. The prevalenc e of lifetime affective, alcohol, and substance use disorders was sign ificantly higher and lifetime anxiety disorders significantly lower, i n the burn-injured sample. The 12-month postburn prevalences of alcoho l, and substance use disorders were significantly greater in the burn- injured sample. The risk of postburn disorder was significantly greate r for the subjects who had a preburn history of affective, alcohol, or substance use disorder. The risk for developing posttraumatic stress disorder (PTSD) was elevated in the subjects with a preburn affective disorder but not preburn anxiety disorder. Finally, postburn PTSD was associated with a greater length of stay, and greater preburn comorbid ity predicted preburn employment status and tended to lengthen hospita lization.