Substance use and misuse in burn patients: testing the classical hypotheses

Abstract

Aims: We aimed to test whether the three classical hypotheses proposed by Brown and Wolfe (1994) and tested by Chilcoat and Breslau (1998) can be useful understanding trauma in burn patients. This objective was approached using data extracted from the Fenix II project, a prospective study on the psychopathological comorbidities of burn patients. Materials and Methods: As the study has strict inclusion criteria, all patients admitted in the Burn Unit of the University Hospital Vall d'Hebron during a period of two years were incorporated to baseline analyses aiming to test the high risk hypothesis. Only patients screened and followed for psychopathology were included in prospective analyses in order to test the susceptibility and self-medication hypotheses. Results: The high risk hypothesis seems plausible regarding the high proportion of heavy drug addicted patients compared to the general population. The susceptibility hypothesis would explain higher symptomatology in drug consumers. The self-medication hypotheses could be tested partially due to the hospital stay “cleaning” effect, but severity of symptoms was linked to caffeine, nicotine, alcohol and cannabis use. Conclusions: We’ve found that the three classical hypotheses that link traumatic experiences to substance use and misuse can explain different patterns of burn patient’s risk exposition and evolution. References Brown, P. J., & Wolfe, J. (1994). Substance abuse and post-traumatic stress disorder comorbidity. Drug and Alcohol Dependence, 35(1), 51-59. doi: 10.1016/0376-8716(94)90110-4 Chilcoat, H. D., & Breslau, N. (1998). Posttraumatic Stress Disorder and Drug Disorders: Testing Causal Pathways. Arch Gen Psychiatry, 55(10), 913-917. doi: 10.1001/archpsyc.55.10.913