Surgical and psychiatric profile of patients who self-harm by burning in a regional burn unit over an 11-year period.

INTRODUCTION: Patients admitted to hospital for deliberate self-harm by burning (DSHB) provide a challenge for medical, surgical and psychological management. We retrospectively reviewed all the patients admitted to a Scottish regional burn unit with DSHB over an 11-year period to assess demographics and outcome.

METHODS: Ward admission data were used to identify DSHB patients admitted to the South East Scotland regional burn unit in Livingston, UK between 2002 and 2012, as well as a control group of accidental burn patients. Data were extracted concerning burn injury, psychiatric history and inpatient management.

RESULTS: A total of 53 DSHB patients with 58 attendances over the 11-year period were compared to 49 accidental burns patients. Compared to controls, DSHB patients were more likely to be unemployed, live alone and have a previous psychiatric diagnosis (p < 0.01). DSHB patients had more severe burns, a longer hospital stay and were more likely to undergo surgery (p < 0.01). DSHB patients with previous self-harm, suicide attempts and diagnoses of personality and eating disorder all had significantly less severe burns than DSHB patients without these risk factors (p < 0.05).

CONCLUSIONS: In our experience, DSHB patients have more severe burn injuries and require longer, resource-intensive hospital stays. Burn units should have an appropriate specialist psychologist/psychiatrist who works within the Burn multi-disciplinary team to help manage this complex group of patients' healthcare needs and reduce their risk of further self-harm.