DISFIGUREMENT can have profound psychological consequences, but they are poorly understood and hard to predict, according to a research team about to begin a study into the subject.

The degree of disfigurement does not predict an individual’s response, said Nichola Rumsey, of the University of the West of England in Bristol, who will lead the study. “There is a huge difference in the level of adjustment people can make,” she said at the launch of the £500,000 programme funded by the Healing Foundation.

“Many manage really well, but that is not well predicted by the severity, type, or cause of the disfigurement. We want to find out why it is that one person can adapt very quickly and lead a full and active life, while another might end up avoiding social situations.

“We want to unpick the psychological factors so we can learn much more about what helps people adjust.” The project will study 1,500 people who have suffered disfigurement in a variety of ways — through accident, skin disease, cancer, burns, or congenital causes — and follow up a smaller group of 400 over a year to measure the process of adjustment.

The study has the support of Pam Warren, who was badly burnt in the Ladbroke Grove rail crash in October 1999 and spent months wearing a specialist burns mask. She said that the psychological impact of her injuries had been enormous.

Dr Alex Clarke, a clinical psychologist on the plastic surgery ward at the Royal Free Hospital in London, said that only a handful of psychologists were affiliated to plastic surgery departments. Many departments would like to have psychological expertise, but funding remains a barrier. About 400,000 people in Britain live with visible disfigurement. Of the 14,000 admitted to hospital every year with serious burns, more than half are children.

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