Psychiatric morbidity following electrical injury and its effects on cognitive functioning
A. Ramati; L. Rubin, A. Wicklund, N. Pliskin, A. Ammar, J. Fink, E. Bodnar, R. Lee, M. A. Cooper, K. Kelley
General Hospital Psychiatry 2009
Psychiatric difficulties commonly emerge after traumatic injuries such as burns and traumatic brain injury (TBI). In fact, one study  that followed TBI survivors for 30 years after their incident found that 43% of survivors were diagnosed with a DSM-IV Axis I disorder that began after the TBI. Electrical injury is associated with significant psychiatric difficulties including major depressive disorder, anxiety disorders, and PTSD. Dr. Kelley, through the Electricial Truama Research Program (the precursor to CETRI), evaluated 86 EI survivors who were an average of 20 months post-injury. The EI survivors were in a range of stages of recovery (acute, less than 3 months prior to injury; post-acute, between 3 and 24 months prior to injury; and long-term, more than 24 months prior). Her group's research found that long-term phase EI survivors (<24 months post-injury) were 14 times more likely to be diagnosed with two psychiatric disorders when compared to EI survivors who were in the post-acute stage of recovery (between 3 and 24 months out). Table 3 lists the data from the study along with the types of psychiatric diagnoses that were considered. Dr. Kelley's research group also noted an increase in the prevalence of combined PTSD and depression diagnoses from the acute to long-term phases of recovery. Other groups  have noted that anxiety and depression were the most prevalent disorders in burn patients, which suggests that electrical injury results in a distinct pattern of increased psychiatric issues over time compared to other traumatic injuries that also have characteristically associated psychiatric symptoms. These findings establish that psychiatric changes are common among EI patients and that these changes can increase over time. We believe that these findings should compel health care professionals working with EI patients at all phases of recovery to devote careful attention to evaluating EI survivors' psychiatric status and inititate appropriate interventions. We also want to ensure that mental health professionals working with this clincial population are aware that EI survivors may present with multiple psychiatric conditions which can manifest as memory, attention, and executive function deficits.