Citation

Gardner PJ, Knittel-Keren D, Gomez M. Arch. Phys. Med. Rehabil. 2012; 93(4): 623-628.

Affiliation

Department of Clinical Research, St. John's Rehab Hospital, Toronto, Ontario, Canada.

Copyright

(Copyright © 2012, Elsevier Publishing)

DOI

10.1016/j.apmr.2011.11.015

PMID

22365477

Abstract

Gardner PJ, Knittel-Keren D, Gomez M. The posttraumatic stress disorder checklist as a screening measure for posttraumatic stress disorder in rehabilitation after burn injuries. OBJECTIVES: To determine the profile of posttraumatic stress disorder (PTSD) among outpatients with burn injuries referred to psychology in a rehabilitation hospital, and the utility of the Posttraumatic Stress Disorder Checklist-Civilian Version (PCL-C) as a screening measure for PTSD. DESIGN: Retrospective psychological chart review. SETTING: Outpatient burn clinic of a rehabilitation hospital. PARTICIPANTS: Outpatients (N=132) with burns referred to psychology between December 1999 and January 2010. INTERVENTIONS: Psychological evaluation and self-report questionnaires measuring PTSD and depression. MAIN OUTCOME MEASURES: The Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition to assess clinical diagnosis of disorders, PCL-C to measure PTSD, and the Beck Depression Inventory-II to measure depression. RESULTS: Of 132 outpatients, 127 (96%) had work-related injuries, 116 (88%) were men, and 16 (12%) were women. Mean age ± SD at injury was 39.0±11.1 years. Mean time from injury to assessment was 15.7±42.7 months. Burn etiology included: electrical (46.2%), scald (28.0%), flame (16.7%), chemical (5.3%), and contact (3.8%). Most patients (75%) were diagnosed with PTSD, either clinical (39.4%) or subclinical (35.6%). PTSD (clinical or subclinical) was frequently diagnosed in the following etiology groups: scald (85.7%), flame (77.3%), and electrical (74.6%). There were significant relationships between PTSD and depression (P<.001), and between subclinical PTSD and adjustment disorder (P<.03). PCL-C mean scores ± SD in the clinical and subclinical PTSD groups were 59.7±8.9 and 43.5±15.6, respectively. A PCL-C total score of 50 or higher had a sensitivity of 90% and specificity of 79% for PTSD diagnosis. CONCLUSIONS: There was a high prevalence of PTSD (clinical or subclinical) among outpatients with burns referred to psychology. Prospective screening of psychological symptoms, clinical assessment, and intervention is warranted, especially for patients with work-related burn injuries. Our results suggest that PCL-C is a useful screening measure for PTSD in patients with burns.

Language: en