Prevalence of psychiatric, addiction and forensic pathology resulting in burn injury: Treating the ‘mad, bad and sad.’

Ms Florencia Moraga Masson1, Elizabeth  Concannon, Lindsay  Damkat-Thomas, Ivo  Damkat-Thomas, William  Alexander, John  E. Greenwood, Mr  Nicholas Solanki

1Royal Adelaide Hospital, , Australia


Burn injuries frequently arise as a consequence of a variety of mental health issues. However, the prevalence of addiction, forensic issues and pre-existing psychiatric diagnoses in burn patients and the impact this can have to hospital admissions is not well understood.

This research investigated how pre-existing psychiatric diagnoses impact presentations to an adult burn service compared with the general burn population; as well as an examination of burn healing trends and patterns of presentation involving drugs, alcohol and forensic issues.

This is a retrospective study of 71 patients with total body surface area (TBSA) greater than 20% admitted to the Royal Adelaide Hospital Burn Unit from 2017-2021. Patients information was collected from Burns Registry of Australia and New Zealand (BRANZ) and from electronic health records. This study follows up previous investigation of similar burn related aetiology carried out by Alexander et al in 2015. (1)

Patients with pre-existing psychiatric diagnoses spent longer in hospital, required more surgical procedures and were more likely to have alcohol/drug and forensic involvement to their presentation. Significantly, half of the patients admitted to hospital with a TBSA greater than 20% had psychiatric or drug/alcohol involvement with their admission. Of those that had a pre-existing psychiatric diagnoses, 50% had non-accidental burns.

It is imperative that burn centres are well trained to manage complex psychiatric conditions and extensive drug/alcohol misuse which contribute to major burns presentations. Preventative measures must be targeted at these vulnerable patient groups given the increased risk of burns.

1. Alexander W, Coghlan P, Greenwood JE. A 365-day view of the difficult patients treated in an Australian adult burn centre.


Florencia Moraga Masson is a 5th year Medical Student at the University of Adelaide. She has an interest in burns and trauma surgery.

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