Distinct depression and PTSD symptom trajectories among adult burns survivors: Findings from the ABLE study.

Abstract

This study identifies and characterises changes over time in depression and post-traumatic stress disorder (PTSD) symptoms in hospitalised adult burn survivors to inform mental-health treatment and management. 274 adults admitted to a tertiary burns centre in Queensland, Australia between 01 Oct 2015 and 31 Dec 2017 were recruited. Personal, environmental, injury and treatment data were collected at baseline, 3, 6 and 12 months post-burn, in addition to depression symptoms [Patient Health Questionaire-9 (PHQ-9)] and PTSD symptoms [PTSD Checklist-Civilian (PCL-C)]. Trajectory modelling identified distinct groups for depression and PTSD separately, based on changes in symptom severity over 12-months. Three distinct trajectory groups were identified for PHQ-9: 'Always Mild', 'Always Moderate' and 'Moderately-Severe to Moderate', and for PCL-C: 'Always Low', 'Always Moderate' and 'High to Moderate'. Pre-injury mental health diagnoses and intentional injuries were observed more frequently in both the PHQ-9 'Moderately-Severe to Moderate' and the PCL-C 'High to Moderate' groups. Symptoms of depression and PTSD in adult burn survivors decrease over the first 12 months post-discharge. However, the magnitude of change, and factors associated with change, vary among identified participant subgroups, and must be considered when planning treatment.