Objective: This study assessed the role of self-reported facial scar severity as a possible influencing factor on self-esteem and depressive symptoms in patients with facial burns. Method: A prospective multicentre cohort study with a 6 months follow-up was conducted including 132 patients with facial burns. Patients completed the Patient and Observer Scar Assessment Scale, the Rosenberg Self-esteem Scale and the Hospital Anxiety and Depression Scale. Structural Equation Modeling was used to assess the relations between depressive symptoms, self-esteem and scar severity. Results: The model showed that patient-rated facial scar severity was not predictive for self-esteem and depressive symptoms six months post-burn. There was, however, a significant relationship between early depressive symptoms and both patient-rated facial scar severity and subsequent self-esteem. The variables in the model accounted for 37% of the variance in depressive symptoms six months post-burn and the model provided a moderately well-fitting representation of the data. Conclusion: The study suggests that self-esteem and depressive symptoms were not affected by self-reported facial scar severity but that earlier depressive symptoms were indicative for a more severe self-reported facial scar rating. Therefore, routine psychological screening during hospitalisation is recommended in order to identify patients at risk and to optimise their treatment.

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doi.org/10.1016/j.genhosppsych.2013.12.001, hdl.handle.net/1765/63270
General Hospital Psychiatry
Erasmus MC: University Medical Center Rotterdam

Hoogewerf, C.J, van Baar, M.E, Middelkoop, E, & Van Loey, N.E.E. (2014). Impact of facial burns: Relationship between depressive symptoms, self-esteem and scar severity. General Hospital Psychiatry, 36(3), 271–276. doi:10.1016/j.genhosppsych.2013.12.001