Psychological Management of the Severely Burned Patient: A Case Series of 14 Patients

Abstract: Background: Severe burns represent a dual physical and psychological aggression. Psychological sequelae, often underestimated, may significantly compromise global recovery outcomes. This study aims to identify the main psychological disorders occurring during the acute phase in severely burned patients and to describe the management modalities implemented. Methods: A retrospective descriptive study conducted over 18 months in the Department of Reconstructive, Plastic and Burns Surgery at Mohammed VI University Hospital, Marrakech. Fourteen patients hospitalized in the burn intensive care unit who developed a documented psychological disorder during the acute phase were included. Results: Mean age was 19 years (range: 8–60 years). Female predominance was noted (64.3%, n=9), with a sex ratio of 0.55. Burns were accidental in 80% of cases, primarily caused by flame. Mean total body surface area burned (TBSA) was 26% (range: 3–45%). Mean hospital stay was 45 days (range: 15 days–7 months). Post-traumatic stress disorder (PTSD) was the predominant disorder (60% of cases). The onset of psychiatric symptoms was earlier in patients with a history of substance use (mean: 4 days) compared to non-users (mean: 15 days). Favorable outcome was achieved with simple psychological follow-up in 60% of cases; specialized psychiatric management with pharmacological treatment was required in 33% of cases. Conclusion: Early and multidisciplinary psychological care is essential in severely burned patients. A positive therapeutic relationship provides an auxiliary psychic containment that profoundly influences the patient’s overall recovery.