Suicidality after burn injuries: A systematic review.

Burn survivors may be at increased risk for suicide due to the nature of their injury and psychiatric comorbidities. The purpose of this review is to assess the evidence as to the prevalence of suicidal ideations and behaviors (attempts and completed suicides) in burn survivors as well as evaluate risk and protective factors. PubMed, EMBASE, CINAHL, Cochrane, PsycINFO and Web Science databases were searched using search terms regarding suicide, suicidality and burn. Fourteen full text manuscripts and two published abstracts were included in the review. Overall, burn survivors demonstrate elevated suicidal ideations and higher lifetime prevalence of suicide attempts compared to the general population. There is mixed evidence as to rates of completed suicide post-burn injury, though rates appear to be relatively low. Risk factors include pain at discharge, perceived level of disfigurement, premorbid psychiatric comorbidities and past suicide attempts. Results of this systematic review shed light on the scarcity of data on rates of suicidality among burn survivors which is surprising given the multiple risk factors burn survivors possess including chronic pain, sleep disturbances, history of substance abuse, post-traumatic stress disorder, social isolation and depression which are linked to suicidality in the general population. Suicide risk screening should be included as an integral part burn survivors' care and more research is needed to better understand the magnitude of this phenomena and offer targeted interventions to vulnerable individuals.