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.

Depressive symptoms, Facial burn injury, POSAS, Scar severity, Self-esteem
dx.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