{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,11,1]],"date-time":"2026-11-01T10:58:01Z","timestamp":1793530681337,"version":"4.5.0"},"reference-count":43,"publisher":"MDPI AG","issue":"3","license":[{"start":{"date-parts":[[2025,8,8]],"date-time":"2025-08-08T00:00:00Z","timestamp":1754611200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100003417","name":"German Statutory Accident Insurance (Deutsche Gesetzliche Unfallversicherung, DGUV)","doi-asserted-by":"publisher","award":["FR-268"],"award-info":[{"award-number":["FR-268"]}],"id":[{"id":"10.13039\/501100003417","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["EBJ"],"abstract":"<jats:p>Background: Severe burn injuries often lead to lasting physical and psychological consequences. 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\u2014Revised (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 underscore the importance of early PTSD screening and integrated psychological-somatic rehabilitation to improve long-term recovery and quality of life.<\/jats:p>","DOI":"10.3390\/ebj6030043","type":"journal-article","created":{"date-parts":[[2025,8,8]],"date-time":"2025-08-08T08:09:35Z","timestamp":1754640575000},"page":"43","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":11,"title":["Post-Traumatic Stress Disorder (PTSD) Is Associated with Increased Physical Skin Symptom Burden Following Severe Burn Injuries: Subgroup Analysis of a Multicenter Prospective Cohort"],"prefix":"10.3390","volume":"6","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-1278-0505","authenticated-orcid":false,"given":"Felix J.","family":"Klimitz","sequence":"first","affiliation":[{"name":"Department of Surgery, Division of Plastic Surgery, Yale School of Medicine, New Haven, CT 06510, USA"},{"name":"Department of Hand-, Plastic and Reconstructive Surgery, Microsurgery, Burn Center, BG Trauma Center Ludwigshafen, University of Heidelberg, 67071 Ludwigshafen, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Martin","family":"Aman","sequence":"additional","affiliation":[{"name":"Department of Hand, Replantation, and Microsurgery, BG Trauma Center Berlin, Chair of Hand, Replantation, and Microsurgery, Charit\u00e9\u2014Universit\u00e4tsmedizin Berlin, 10117 Berlin, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0765-4790","authenticated-orcid":false,"given":"Hubert","family":"Neubauer","sequence":"additional","affiliation":[{"name":"Department of Hand-, Plastic and Reconstructive Surgery, Microsurgery, Burn Center, BG Trauma Center Ludwigshafen, University of Heidelberg, 67071 Ludwigshafen, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1063-7510","authenticated-orcid":false,"given":"Annette","family":"Stolle","sequence":"additional","affiliation":[{"name":"Department of Hand-, Plastic and Reconstructive Surgery, Microsurgery, Burn Center, BG Trauma Center Ludwigshafen, University of Heidelberg, 67071 Ludwigshafen, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hans","family":"Ziegenthaler","sequence":"additional","affiliation":[{"name":"Rehabilitation Center, Graefliche Kliniken-Moritz Klinik GmbH, 07639 Bad Klosterlausnitz, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0004-3065-4352","authenticated-orcid":false,"given":"Tobias","family":"Niederegger","sequence":"additional","affiliation":[{"name":"Department of Hand-, Plastic and Reconstructive Surgery, Microsurgery, Burn Center, BG Trauma Center Ludwigshafen, University of Heidelberg, 67071 Ludwigshafen, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Adriana C.","family":"Panayi","sequence":"additional","affiliation":[{"name":"Department of Hand, Replantation, and Microsurgery, BG Trauma Center Berlin, Chair of Hand, Replantation, and Microsurgery, Charit\u00e9\u2014Universit\u00e4tsmedizin Berlin, 10117 Berlin, Germany"},{"name":"Department of Oral and Maxillofacial Surgery, Charit\u00e9\u2014Universit\u00e4tsmedizin Berlin, Corporate Member of Freie Universit\u00e4t Berlin, Humboldt-Universit\u00e4t zu Berlin, and Berlin Institute of Health, 10099 Berlin, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Gabriel","family":"Hundeshagen","sequence":"additional","affiliation":[{"name":"Department of Hand-, Plastic and Reconstructive Surgery, Microsurgery, Burn Center, BG Trauma Center Ludwigshafen, University of Heidelberg, 67071 Ludwigshafen, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3402-2860","authenticated-orcid":false,"given":"Ulrich","family":"Kneser","sequence":"additional","affiliation":[{"name":"Department of Hand-, Plastic and Reconstructive Surgery, Microsurgery, Burn Center, BG Trauma Center Ludwigshafen, University of Heidelberg, 67071 Ludwigshafen, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Leila","family":"Harhaus","sequence":"additional","affiliation":[{"name":"Department of Hand, Replantation, and Microsurgery, BG Trauma Center Berlin, Chair of Hand, Replantation, and Microsurgery, Charit\u00e9\u2014Universit\u00e4tsmedizin Berlin, 10117 Berlin, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2025,8,8]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"1406","DOI":"10.1016\/j.burns.2024.02.017","article-title":"Recovery of 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