Post-Traumatic Stress Disorder (PTSD) Is Associated with Increased Physical Skin Symptom Burden Following Severe Burn Injuries: Subgroup Analysis of a Multicenter Prospective Cohort

Background: Severe burn injuries often lead to lasting physical and psychological con-sequences. Post-traumatic stress disorder (PTSD) is common among burn survivors and may be influenced by persistent somatic complaints. This study examined whether PTSD is associated with a higher burden of physical symptoms during and after inpatient rehabilitation. Methods: We conducted a subgroup analysis of a multicenter prospective cohort study involving 103 adult burn patients in inpatient rehabilitation. Based on Impact of Event Scale-Revised (IES-R) scores and clinical evaluation, patients were grouped as PTSD (n=43) or No PTSD (n=60). Physical symptoms assessed included skin dryness (xerosis), temperature sensitivity (cold/heat), numbness, skin tightness, and increased sweating. Results: Patients with PTSD reported significantly more physical symptoms at follow-up than those without PTSD: xerosis (74% vs. 50%, p=0.03), cold sensitivity (61% vs. 35%, p=0.02), heat sensitivity (63% vs. 39%, p=0.03), numbness (63% vs. 33%, p=0.006), skin tightness (82% vs. 52%, p=0.004), and sweating (45% vs. 19%, p=0.01). PTSD patients also had more severe burns, reflected in higher full-thickness TBSA (2% vs. 0%, p=0.03) and elevated ABSI scores (median 6 vs. 5, p=0.04). Conclusion: PTSD is associated with a higher and more persistent burden of physical skin symptoms after severe burns. These findings highlight the need for early PTSD screening and integrated psychological-somatic rehabilitation to improve long-term recovery and quality of life.