Unseen Scars: Psychiatric Comorbidity, Intentional Burns, and Psychosocial Factors among Patients with Burn Injuries – A Cross-sectional Study from a Tertiary Care Center in North India

Background: Burn injuries are associated with profound physical disfigurement and psychological trauma. However, psychiatric comorbidities and psychosocial risk factors in burn patients, particularly in the Indian context, remain inadequately explored. Aim: The aim of this study was to assess the prevalence of psychiatric morbidity and delineate psychosocial and behavioral risk factors in patients admitted with burn injuries at a tertiary care center in North India. Methodology: In this cross-sectional study conducted from January 2023 to March 2024, 104 adult inpatients at PGIMER, Chandigarh, were assessed. Psychiatric diagnoses were established using the Diagnostic and Statistical Manual of Mental Disorders-5. Patients identified with psychiatric morbidity were further assessed using the Patient Health Questionnaire-9 (PHQ-9), Generalized Anxiety Disorder-7 scale (GAD-7), Barratt Impulsiveness Scale-15, Levels of Self-Criticism Scale, Regret Elements Scale, Everyday Discrimination Scale (EDS), Heightened Vigilance Scale, and Iowa Personality Disorder Screen (IPDS). The characteristics of a burn were documented using the World Health Organization–Global Burn Registry form. Group comparisons were made between those with and without psychiatric diagnoses. Results: Psychiatric morbidity (excluding nicotine dependence) was present in 18.3% ( n = 19) of patients. The most common diagnoses were substance use disorders (25%) and depressive disorders (7.7%). Intentional self-inflicted burns occurred in 9.6% ( n = 10) of patients, of whom 80% ( n = 8) had psychiatric comorbidity. Among those with psychiatric morbidity, 47.3% of patients had moderate-to-severe depressive symptoms (PHQ-9), and 31.6% of patients had mild-to-moderate anxiety symptoms (GAD-7). In addition, 84.2% of patients reported perceived discrimination (EDS >12), and 26.3% of patients screened positive for personality disorders (IPDS). Conclusions: Nearly one-fifth of patients with burn injuries had diagnosable psychiatric disorders, and a significant subset of patients experienced psychological distress, perceived stigma, and self-injurious behaviors.