We report on a prospective study of 45 patients with burn injuries admitted to a major burn unit in the greater Athens area. The study aimed to explore the prevalence of psychological and psychiatric disorders among burn survivors. The sample comprised all consecutive cases of adult burn patients in a 6-month period. Personal interviews were conducted by the administration of the Langner scale and the DSM-III-R Structured Clinical Interview. Twelve months later, 30 patients of the baseline sample were reexamined. Psychological impairment was found to be 45.5 and 40% at the baseline and follow-up assessments, respectively. The extent of burns was found to be associated with psychological impairment. The prevalence of psychiatric disorders (any DSM-III nosological entity) reached 46.6% at both baseline and follow-up examinations. Posttraumatic stress disorder was diagnosed in 17.8 and 20.0% of burn survivors at the baseline and the 12-month follow-up assessments, respectively. Logistic regression analysis revealed that face disfigurement was the only burn characteristic significantly associated with the presence of psychiatric morbidity. The results of the study suggest that the extent of burns is not so important when compared to the possibility of disfigurement from the point of risk of developing a psychiatric disorder. Copyright 2001 S. Karger AG, Basel