Preinjury psychiatric illness and postinjury adjustment in adult burn survivors

The impact of preinjury DSM-III-R anxiety, mood, and alcohol and substance abuse disorders, determined by using the Structured Clinical Interview for DSM-III-R, nonpatient version (SCID-NP), on postinjury adjustment was examined prospectively in a consecutive series of 98 adult patients admitted to a regional burn center and followed for 1 year. The subjects were grouped according to SCID diagnoses: 1) any preburn mood and/or anxiety diagnosis; 2) preburn alcohol abuse or dependence diagnosis; or 3) any preburn diagnosis (i. e., any of the above diagnoses). 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 maintained at the 1-year follow-up. Similarly, trait neuroticism had an early negative impact on adjustment, while trait extroversion had both an early and late positive effect on adjustment.