1/5. Young burned children: the course of acute stress and physiological and behavioral responses.OBJECTIVE: Symptoms of posttraumatic stress disorder (PTSD) are a focus of much research with older children, but little research has been conducted with young children, who account for about 40% of all pediatric burn injuries. This is a longitudinal study of 72 acutely burned children (12-48 months old) that assessed the course of acute posttraumatic symptoms and physiological reactivity. METHOD: parents were interviewed shortly after their child was admitted to the hospital and 1 month after discharge. PTSD symptoms were measured with the Diagnostic interview for Children and Adolescents (DICA) module. nurses recorded the child's physiological data throughout the hospital stay. The child's physical and behavioral responses were assessed in a laboratory at about 1 month after discharge. RESULTS: Reduced social smiling in the children was related to PTSD symptoms, as measured by the DICA, and heart rate at 24 hours and 7 days. Reduced vocalization was related to the child's rating of pain at 24 hours. smiling and vocalizations were also related to some DICA cluster scores but not avoidance. CONCLUSIONS: Preschool children admitted to a burn unit demonstrated PTSD symptoms and physiological reactivity. There was a relation to the frequency of smiles and vocalizations.- - - - - - - - - - ranking = 1keywords = stress disorder (Clic here for more details about this article) |
2/5. Posttraumatic stress disorder in the child of an adult burn victim: a case report and review of the literature.Adults with a myriad of medical and surgical conditions are at risk for pain, delirium, and disfigurement. Needless to say, these critical illnesses are profoundly stressful for patients and their caregivers. However, physicians rarely consider the reactions of children to their parents' illnesses. The article presents the case of a 15-year-old girl who developed posttraumatic stress disorder following her mother's severe burn and complicated course in a critical care unit; the case is used to discuss strategies for the detection of psychological vulnerability and for the implementation of care. By learning more about the children of adult patients, by screening for interpersonal dysfunction, and by maximizing support systems, clinicians can improve function and minimize distress.- - - - - - - - - - ranking = 5keywords = stress disorder (Clic here for more details about this article) |
3/5. The King's Cross fire. Part 2: The psychological injuries.This paper describes the experiences of six people who received severe burns in the King's Cross Underground Station fire of 1987. They all developed post-traumatic stress disorder to varying levels of intensity and the problems of psychological intervention as they related to the patients' different mental defence mechanisms are outlined.- - - - - - - - - - ranking = 1keywords = stress disorder (Clic here for more details about this article) |
4/5. Recognition and treatment of the post-traumatic stress disorder in the burn victim.In 1980 the third edition of the diagnostic and statistical manual of mental disorders of the American Psychiatric association (DSM-III) provided the first descriptive classification for post-traumatic stress disorder as a unique diagnostic entity. Since then, many reports describing this condition in vietnam war veterans have appeared, as well as occasional reports of the disorder after civilian trauma. We have found only one previous report of this disorder as a sequela to thermal injury. This article presents two illustrative case reports of burn victims suffering from post-traumatic stress disorder, highlighting the phenomenology leading to the diagnosis. The treatment and outcome are also presented. The importance of recognizing and treating this disorder in burn victims is discussed. Treatment results in improved compliance through all phases of therapy and an overall decrease in patient morbidity, especially psychologic problems. The need for psychiatric consultation, evaluation, and follow-up of the burn victim is emphasized.- - - - - - - - - - ranking = 6keywords = stress disorder (Clic here for more details about this article) |
5/5. Sexual dysfunction and the patient with burns.Sexual dysfunction in patients with burns has received only limited attention in the literature on burn care. We present five patients with burns whose sexual dysfunction responded to an eclectic treatment approach. A more extensive discussion on the relationship between post-traumatic stress disorder, other psychopathology, and sexual dysfunction in patients with burn injuries is presented. Neuroendocrinological, psychopathologic, psychodynamic, and physiological mechanisms that may be at play in patients with burns are proposed. The possible impact of post-traumatic stress disorder on sexuality is discussed. The illustrated cases suggest that sexual side effects of psychotropics, although fairly common, should not get in the way of proper use of antidepressants and antianxiety medications during the initial phase of treatment. Psychotropic and other commonly used medications in patients with burns, and the possible mechanisms of actions on sexuality, are reviewed.- - - - - - - - - - ranking = 2keywords = stress disorder (Clic here for more details about this article) |