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PSYCH up2date 2015; 9(01): 21-32
DOI: 10.1055/s-0034-1387455
Essstörungen, somatische Belastungsstörungen, Schlafstörungen und sexuelle Funktionsstörungen

Biopsychosoziale Aspekte in der interdisziplinären Verbrennungsmedizin

Stefanie Jasper
,
Hans-Oliver Rennekampff
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Kernaussagen

Fortschritte in der Verbrennungsmedizin ermöglichen es bei immer mehr Patienten – auch mit schwersten Verbrennungen – das Überleben zu sichern. Neben diesem erfreulichen Trend ergeben sich dennoch für die Betroffenen körperliche Folgen wie Narben, Funktionseinschränkungen, Schmerzen und psychische Beschwerden wie posttraumatische Belastungsstörungen und Depressionen. Auch psychische Beeinträchtigungen durch Körperbildveränderungen und Entstellungen müssen berücksichtigt werden, da diese sozialen Rückzug, verringertes Selbstwertgefühl und reduzierte Lebensqualität zur Folge haben.

Wegen der Auswirkungen auf die körperlichen Funktionen als auch auf das psychische Befinden sollte sowohl in der Akutversorgung von Verbrennungspatienten als auch in der poststationären Weiterbehandlung eine multidisziplinäre verbrennungsspezifische Behandlung erfolgen.

Aufgrund der resultierenden hohen Belastungen aufseiten der Betroffenen sollten psychotherapeutische Therapieangebote in die Versorgung von Brandopfern integriert werden. Dies kann die Krankheitsverarbeitung und Adhärenz der Patienten für die lang dauernde Behandlung verbessern.



Publication History

Publication Date:
12 January 2015 (online)

© Georg Thieme Verlag KG
Stuttgart · New York

 

  • Literatur

  • 1 Rennekampff HO. Behandlung der Verbrennungswunde in der Praxis. Notfall- und Hausarztmedizin 2008; 34: 360-367
    Article in Thieme ConnectGoogle Scholar
  • 2 Jackson DM. The diagnosis of the depth of burning. Br J Surg 1953; 40: 588-596
    CrossrefPubMedGoogle Scholar
  • 3 Jasper S, Rennekampff HO, de Zwaan M. Psychische Komorbidität, Körperbildprobleme und psychotherapeutische Interventionen bei Brandopfern: ein Überblick. Psychother Psychosom Med Psychol 2013; 63: 423-428
    Article in Thieme ConnectPubMedGoogle Scholar
  • 4 Durani P, McGrouther DA, Ferguson MW. Current scales for assessing human scarring: a review. J Plast Reconstr Aesthet Surg 2009; 62: 713-720
    CrossrefPubMedGoogle Scholar
  • 5 Mason ST, Esselman P, Fraser R. et al. Return to work after burn injury: a systematic review. J Burn Care Res 2012; 33: 101-109
    CrossrefPubMedGoogle Scholar
  • 6 Ripper S, Renneberg B, Landmann C. et al. Adherence to pressure garment therapy in adult burn patients. Burns 2009; 35: 657-664
    CrossrefPubMedGoogle Scholar
  • 7 Thombs BD, Bresnick MG, Magyar-Russell G. Depression in survivors of burn injury: a systematic review. Gen Hosp Psychiatry 2006; 28: 494-502
    CrossrefPubMedGoogle Scholar
  • 8 Thombs BD, Haines JM, Bresnick MG. et al. Depression in burn reconstruction patients: symptom prevalence and association with body image dissatisfaction and physical function. Gen Hosp Psychiatry 2007; 29: 14-20
    CrossrefPubMedGoogle Scholar
  • 9 Jacobi F, Wittchen HU, Holting C. et al. Prevalence, co-morbidity and correlates of mental disorders in the general population: results from the German Health Interview and Examination Survey (GHS). Psychol Med 2004; 34: 597-611
    CrossrefPubMedGoogle Scholar
  • 10 Thombs BD, Bresnick MG, Magyar-Russell G. et al. Symptoms of depression predict change in physical health after burn injury. Burns 2007; 33: 292-298
    CrossrefPubMedGoogle Scholar
  • 11 Van Loey NE, Van Son MJ. Psychopathology and psychological problems in patients with burn scars: Epidemiology and management. Am J Clin Dermatol 2003; 4: 245-272
    CrossrefPubMedGoogle Scholar
  • 12 Ehde DM, Patterson DR, Wiechman SA. et al. Post-traumatic stress symptoms and distress following acute burn injury. Burns 1999; 25: 587-592
    CrossrefPubMedGoogle Scholar
  • 13 McKibben JB, Bresnick MG, Wiechman Askay SA. et al. Acute stress disorder and posttraumatic stress disorder: a prospective study of prevalence, course, and predictors in a sample with major burn injuries. J Burn Care Res 2008; 29: 22-35
    CrossrefPubMedGoogle Scholar
  • 14 Lawrence JW, Fauerbach JA, Heinberg L. et al. Visible vs hidden scars and their relation to body esteem. J Burn Care Rehab 2004; 25: 25-32
    PubMedGoogle Scholar
  • 15 Madianos MG, Papaghelis M, Ioannovich J. et al. Psychiatric disorders in burn patients: A follow-up study. Psychother Psychosom 2001; 70: 30-37
    CrossrefPubMedGoogle Scholar
  • 16 Palmu R, Suominen K, Vuola J. et al. Mental disorders after burn injury: a prospective study. Burns 2011; 37: 601-609
    CrossrefPubMedGoogle Scholar
  • 17 Taal LA, Faber AW. Posttraumatic stress and maladjustment among adult burn survivors 1–2 years postburn. Burns 1998; 24: 285-292
    CrossrefPubMedGoogle Scholar
  • 18 Van Loey NE, Maas CJ, Faber AW. et al. Predictors of chronic posttraumatic stress symptoms following burn injury: Results of a longitudinal study. J Trauma Stress 2003; 16: 361-369
    CrossrefPubMedGoogle Scholar
  • 19 Wisely JA, Wilson E, Duncan RT. et al. Pre-existing psychiatric disorders, psychological reactions to stress, and the recovery of burn survivors. Burns 2010; 36: 183-191
    CrossrefPubMedGoogle Scholar
  • 20 Pavan C, Grasso G, Constantini MV. et al. Accident proneness and impulsiveness in an Italian group of burn patients. Burns 2009; 35: 247-255
    CrossrefPubMedGoogle Scholar
  • 21 Fauerbach JA, Richter L, Lawrence JW. Regulating acute posttrauma distress. J Burn Care Rehab 2002; 23: 249-257
    CrossrefPubMedGoogle Scholar
  • 22 Yu BH, Dimsdale JE. Posttraumatic stress disorder in patients with burn injuries. J Burn Care Rehab 1999; 20: 426-433
    CrossrefPubMedGoogle Scholar
  • 23 Lawrence JW, Fauerbach JA. Personality, coping, chronic stress, social support and ptsd symptoms among adult burn survivors: A path analysis. J Burn Care Rehab 2003; 24: 63-72
    CrossrefPubMedGoogle Scholar
  • 24 Klinge K, Chamberlain DJ, Redden M. et al. Psychological adjustments made by postburn injury patients: An integrative literature review. J Adv Nurs 2009; 65: 2274-2292
    CrossrefPubMedGoogle Scholar
  • 25 Fauerbach JA, Lawrence J, Haythornthwaite J. et al. Preinjury psychiatric illness and postinjury adjustment in adult burn survivors. Psychosomatics 1996; 37: 547-555
    CrossrefPubMedGoogle Scholar
  • 26 Shakespeare V. Effect of small burn injury on physical, social and psychological health at 3–4 months after discharge. Burns 1998; 24: 739-744
    CrossrefPubMedGoogle Scholar
  • 27 Hoogewerf CJ, van Baar ME, Middelkoop E. et al. Patient reported facial scar assessment: directions for the professional. Burns 2014; 40: 347-353
    CrossrefPubMedGoogle Scholar
  • 28 Lawrence JW, Mason ST, Schomer K. et al. Epidemiology and impact of scarring after burn injury: A systematic review of the literature. J Burn Care Res 2012; 33: 136-146
    CrossrefPubMedGoogle Scholar
  • 29 Lawrence JW, Fauerbach JA, Thombs BD. A test of the moderating role of importance of appearance in the relationship between perceived scar severity and body-esteem among adult burn survivors. Body Image 2006; 3: 101-111
    CrossrefPubMedGoogle Scholar
  • 30 Hoogewerf CJ, van Baar ME, Middelkoop E. et al. Impact of facial burns: relationship between depressive symptoms, self-esteem and scar severity. Gen Hosp Psychiatry 2014; 36: 271-276
    CrossrefPubMedGoogle Scholar
  • 31 Rumsey N, Harcourt D. Body image and disfigurement: Issues and interventions. Body Image 2004; 1: 83-97
    CrossrefPubMedGoogle Scholar
  • 32 Borah GL, Rankin MK. Appearance is a function of the face. Plast Reconstr Surg 2010; 125: 873-878
    CrossrefPubMedGoogle Scholar
  • 33 Fauerbach JA, Heinberg LJ, Lawrence JW. et al. Effect of early body image dissatisfaction on subsequent psychological and physical adjustment after disfiguring injury. Psychosom Med 2000; 62: 576-582
    CrossrefPubMedGoogle Scholar
  • 34 Thombs BD, Notes LD, Lawrence JW. et al. From survival to socialization: A longitudinal study of body image in survivors of severe burn injury. J Psychosom Res 2008; 64: 205-212
    CrossrefPubMedGoogle Scholar
  • 35 Pallua N, Künsebeck HW, Noah EM. Psychosocial adjustments 5 years after burn injury. Burns 2003; 29: 143-152
    CrossrefPubMedGoogle Scholar
  • 36 Goldenberg JL, McCoy SK, Pyszczynski T. et al. The body as a source of self-esteem: The effect of mortality salience on identification with one’s body, interest in sex, and appearance monitoring. J Pers Soc Psychol 2000; 79: 118-130
    CrossrefPubMedGoogle Scholar
  • 37 Van Loey NE, Faber AW, Taal LA. A European hospital survey to determine the extent of psychological services offered to patients with severe burns. Burns 2001; 27: 23-31
    CrossrefPubMedGoogle Scholar
  • 38 Van Loey NEE, Faber AW, Taal LA. Do burn patients need burn specific multidisciplinary outpatient aftercare: research results. Burns 2001; 27: 103-110
    CrossrefPubMedGoogle Scholar
  • 39 Flatten G, Bär O, Becker K. et al. S2-Diagnostik und Behandlung von akuten Folgen psychischer Traumatisierung. Trauma und Gewalt 2011; 3: 214-221
    Google Scholar
  • 40 Haythornthwaite JA, Lawrence JW, Fauerbach JA. Brief cognitive interventions for burn pain. Ann Behav Med 2001; 23: 42-49
    CrossrefPubMedGoogle Scholar
  • 41 Moore M, Fagan S, Nejad S. et al. The role of a dedicated staff psychiatrist in modern burn centers. Ann Burns Fire Disasters 2013; 26: 213-216
    PubMedGoogle Scholar
  • 42 Low JF, Dyster-Aas J, Willebrand M. et al. Chronic nightmares after severe burns: risk factors and implications for treatment. J Burn Care Rehab 2003; 24: 260-267
    CrossrefPubMedGoogle Scholar
  • 43 Shepherd L, Tattersall H, Buchanan H. Looking in the mirror for the first time after facial burns: A retrospective mixed methods study. Burns 2014; 0 [in press], http://dx.doi.org/10.1016/j.burns.2014.03.011
    CrossrefPubMedGoogle Scholar
  • 44 Shepherd L, Begum R. Helping burn patients to look at their injuries: How confident are burn care staff and how often do they help?. Burns 2014; 0 [in press], http://dx.doi.org/10.1016/j.burns.2014.02.017
    CrossrefPubMedGoogle Scholar
  • 45 Flatten G, Wälte D, Perlitz V. Self-efficacy in acutely traumatized patients and the risk of developing a posttraumatic stress syndrome. Psychosoc Med 2008; 5 Doc05 0
    Google Scholar
  • 46 Rosenbach C, Renneberg B. Positive change after severe burn injuries. J Burn Care Res 2008; 29: 638-643
    CrossrefPubMedGoogle Scholar
  • 47 Cooper R, Burnside I. Three years of an adult burns support group: an analysis. Burns 1996; 22: 65-68
    CrossrefPubMedGoogle Scholar
  • 48 Newell R, Marks I. Phobic nature of social difficulty in facially disfigured people. Br J Psychiatry 2000; 176: 177-181
    CrossrefPubMedGoogle Scholar
  • 49 Blakeney P, Thomas C, Holzer 3rd C. et al. Efficacy of a short-term, intensive social skills training program for burned adolescents. J Burn Care Rehab 2005; 26: 546-555
    CrossrefPubMedGoogle Scholar
  • 50 Bessell A, Moss TP. Evaluating the effectiveness of psychosocial interventions for individuals with visible differences: A systematic review of the empirical literature. Body Image 2007; 4: 227-238
    CrossrefPubMedGoogle Scholar
  • 51 Robinson E, Rumsey N, Partridge J. An evaluation of the impact of social interaction skills training for facially disfigured people. Brit J Plast Surg 1996; 49: 281-289
    CrossrefPubMedGoogle Scholar
  • 52 Kleve L, Rumsey N, Wyn-Williams M. et al. The effectiveness of cognitive-behavioural interventions provided at Outlook: a disfigurement support unit. J Eval Clin Pract 2002; 8: 387-395
    CrossrefPubMedGoogle Scholar
  • 53 Wallis-Simon H, Renneberg B. Psychische Faktoren bei schweren Brandverletzungen: Psychotherapeutische Beiträge zur Verbesserung der Lebensqualität. Psychotherapeuten Journal 2009; 8: 142-152
    Google Scholar
  • 54 Van’t Hof E, Cuijpers P, Stein DJ. Self-help and internet-guided interventions in depression and anxiety disorders: a systematic review of meta-analyses. CNS Spectr 2009; 14: 34-40
    CrossrefPubMedGoogle Scholar
  • 55 Partridge J. About changing faces: Promoting a good quality of life for people with visible disfigurements. Burns 1997; 23: 186-187
    CrossrefPubMedGoogle Scholar
  • 56 Clarke A. Managing the psychological aspects of altered appearance: the development of an information resource for people with disfiguring conditions. Patient Educ Couns 2001; 4: 305-309
    Google Scholar
  • 57 Newell R, Clarke M. Evaluation of a self-help leaflet in treatment of social difficulties following facial disfigurement. Int J Nurs Stud 2000; 37: 381-388
    CrossrefPubMedGoogle Scholar
  • 58 Bessell A, Brough V, Clarke A. et al. Evaluation of the effectiveness of face it, a computer-based psychosocial intervention for disfigurement-related distress. Psychol Health Med 2012; 17: 565-577
    CrossrefPubMedGoogle Scholar