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  • 1.
    Low, Aili J. F.
    et al.
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Surgical Sciences, Plastic Surgery.
    Dyster-Aas, Johan
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Neuroscience, Psychiatry, University Hospital.
    Willebrand, Mimmie
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Neuroscience, Psychiatry, University Hospital.
    Ekselius, Lisa
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Neuroscience, Psychiatry, University Hospital.
    Gerdin, Bengt
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Surgical Sciences, Plastic Surgery.
    Psychiatric morbidity predicts perceived burn-specific health 1 year after a burn2012In: General Hospital Psychiatry, ISSN 0163-8343, E-ISSN 1873-7714, Vol. 34, no 2, p. 146-152Article in journal (Refereed)
    Abstract [en]

    Objective:

    Individual factors such as gender, age, coping and personality traits and injury-related factors such as injury severity have been implicated as risk factors for poor perceived health after burns. As psychiatric morbidity is common in individuals who sustain burns, the aim of this study was to examine the effect of preinjury psychiatric problems on perceived health after injury.

    Method:

    A total of 85 consecutive patients treated at a national burn center were prospectively assessed: the patients were interviewed during acute care with the Structured Clinical Interview for DSM-IV Axis I Disorders. One year after injury, perceived health was assessed with the Bum-Specific Health Scale-Brief (BSHS-B). Multiple regression analyses were used to evaluate the predictive effect of preinjury psychiatric history on perceived postinjury health.

    Results:

    Psychiatric morbidity, especially mood disorders, affected outcome for six of the nine BSHS-B subscales, with the covariates mainly being the length of hospital stay and total burn size.

    Conclusion:

    The results show that a history of preinjury psychiatric disorders, especially during the year before the burn, affects perceived outcome regarding both physical and psychological aspects of health 1 year after injury and that it is a risk factor for worse perceived outcome.

  • 2.
    Willebrand, Mimmie
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Neuroscience.
    Presence of psychiatric morbidity and regrets about participation in trauma-related research: A pilot study2008In: General Hospital Psychiatry, ISSN 0163-8343, E-ISSN 1873-7714, Vol. 30, no 5, p. 476-478Article in journal (Refereed)
    Abstract [en]

    OBJECTIVE: Little is known about the characteristics of individuals who regret their participation in trauma-related research. The aim of this pilot study was to evaluate (1) regret after participating in a longitudinal study after a burn and (2) associations with psychiatric morbidity prior to the burn. METHOD: Participants were recruited from a longitudinal study after a burn involving interviews, questionnaires, and psychological testing. Forty-two participants answered questions about regret and positive/negative consequences of participation. RESULTS: Thirty-eight participants reported no regret, while 3 reported the lowest level of regret (1 on a scale of 0-4). All 3 patients with slight regret had psychiatric morbidity prior to the burn. Among the 38 patients without regrets, 23 had prior psychiatric morbidity. Two individuals reported negative consequences of participation, both indicating that the study had elicited negative emotions. CONCLUSIONS: Regret and perceived negative consequences were infrequent. The results suggest that a longitudinal trauma-related research protocol is well tolerated by most patients with burns, despite the presence of prior psychiatric morbidity.

  • 3.
    Willebrand, Mimmie
    et al.
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Neuroscience, Psychiatry, University Hospital.
    Sveen, Josefin
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Neuroscience, Psychiatry, University Hospital.
    Perceived support in parents of children with burns2016In: General Hospital Psychiatry, ISSN 0163-8343, E-ISSN 1873-7714, Vol. 38, no 1, p. 105-108Article in journal (Refereed)
    Abstract [en]

    Objective

    Children sustaining burns that require treatment in a burn center have a need for multiprofessional aftercare services over a prolonged time. So far, there is little research into satisfaction with care and support after pediatric burns. The aim was to investigate parents’ perception of support after pediatric burn and associations with parent, child and injury characteristics.

    Method

    Parents (n= 101) of children aged 0.4–17.8 years completed questionnaires on support, parent’s psychological symptoms and health of the child. Time since injury was 0.1–9.0 years.

    Results

    Perceived lack of psychosocial, medical, societal or family support was reported by 21% of the parents. Lack of support was not associated with injury or sociodemographic characteristics, but it was significantly associated with parents’ symptoms of general anxiety, depression and injury-related fear avoidance, as well as parents’ ratings of their child’s general health and heat sensitivity.

    Conclusion

    Perceived support did not differ on account of burn severity or sociodemographic status. However, care providers should be more attentive to and supportive of parents signaling poorer general health in their child and cognitive beliefs that the child is at risk for harm when active and parents who themselves show signs of psychological symptoms.

  • 4.
    Willebrand, Mimmie
    et al.
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Neuroscience.
    Wikehult, Björn
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Surgical Sciences.
    Ekselius, Lisa
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Neuroscience.
    Acceptance of a trauma-focused survey: Do personality and health matter?2004In: General Hospital Psychiatry, ISSN 0163-8343, E-ISSN 1873-7714, Vol. 26, no 1, p. 70-77Article in journal (Refereed)
    Abstract [en]

    Health evaluations after trauma are often performed by postal surveys, although previous studies show that some participants experience distress reactions afterwards. The aim was to explore how former burn patients react to filling in a trauma-related survey and whether the reactions are related to individual factors. The survey contained 307 questions, of which one was an open question to elicit reactions to participation. Personality was measured with the Swedish universities Scales of Personality, health with the Burn Specific Health Scale-Brief, and psychological health with the Hospital Anxiety and Depression Scale and Impact of Event Scale-Revised. Participants were 78 (67%) adult burn patients, injured on average 3.9 years previously. Three groups of reactions were identified: positive/beneficial (55%), effort/time-consuming (32%), and negative/intrusive (13%). Only four participants expressed that the survey had been intrusive. Negative reactions were associated with maladaptive personality traits, poorer relationships, and more stress symptomatology, but not with burn severity or sociodemographic variables. Patients with self-inflicted injuries were evenly spread across the groups, but those with negative reactions were responsible for most of the group differences in individual factors. While a small subgroup reacted negatively, the majority accepted the trauma-focused survey and even found it beneficial.

  • 5.
    Öster, Caisa
    et al.
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Neuroscience, Psychiatry, University Hospital.
    Sveen, Josefin
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Neuroscience, Psychiatry, University Hospital.
    The psychiatric sequelae of burn injury2014In: General Hospital Psychiatry, ISSN 0163-8343, E-ISSN 1873-7714, Vol. 36, no 5, p. 516-522Article in journal (Refereed)
    Abstract [en]

    Objective: To examine factors predicting psychiatric morbidity, taking into account the full range of psychiatric disorders before and after burn injury. Methods: A cohort of 107 patients consecutively admitted to a Swedish national burn center was examined for lifetime psychiatric morbidity, as well as 94 patients at 1 year postinjury. Sixty-seven individuals, some from that same cohort, were interviewed at 2 to 7 years postinjury. The predictive effects of psychiatric history, personality and other risk factors for psychiatric morbidity following burn were evaluated with multiple regression analyses. Results: The prevalence of having a psychiatric disorder preburn was 57%. One year postinjury 19% had minor or major depression and 23% had subsyndromal or full posttraumatic stress disorder. At 2 to 7 years, 31% fulfilled the criteria for a psychiatric disorder. The strongest contributing factors were a history of psychiatric morbidity and neuroticism. Conclusions: Two-thirds of the patients had a lifetime psychiatric disorder, and one-third had a psychiatric diagnosis 2 to 7 years postburn. Mental health problems can have a major impact on daily life and functional abilities. Thus, identification and treatment of a range of psychiatric disorders, taking into account preburn psychiatric disorders and personality, is important for optimal adjustment after burn.

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