Clin Psychopharmacol Neurosci.  2016 Aug;14(3):295-298. 10.9758/cpn.2016.14.3.295.

Opioid Analgesics and Depressive Symptoms in Burn Patients: What Is the Real Relationship?

Affiliations
  • 1Department of Psychiatry, Hallym University Sacred Heart Hospital, Anyang, Korea.
  • 2Department of Psychiatry, Hallym University Dongtan Sacred Heart Hospital, Hwaseong, Korea.
  • 3Department of Burn Surgery, Hallym University Hangang Sacred Heart Hospital, Seoul, Korea.
  • 4Department of Neuropsychiatry, Hallym University Hangang Sacred Heart Hospital, Seoul, Korea. woldyfig@icloud.com
  • 5Department of Psychiatry, Hallym University Kangnam Sacred Heart Hospital, Seoul, Korea.
  • 6Department of Anatomy and Neurobiology, Hallym University College of Medicine, Chuncheon, Korea.
  • 7Department of Neuropsychiatry, Chung-Ang University Hopital, Seoul, Korea.

Abstract

OBJECTIVE: Major burn injuries are strongly associated with both psychological trauma and severe pain, and opioids are the mainstay analgesics for the treatment of severe burn pain. The objectives of this study are to find the complex relationship between opioid dose, depression, and post-traumatic stress disorder (PTSD) symptoms during the acute management of pain in burn patients.
METHODS
The symptoms of depression and PTSD were assessed in 43 burn patients immediately following wound stabilization and 2 weeks after the initial evaluation.
RESULTS
Total opioid doses and Hamilton Depression Scale (HAMD) scores obtained during the second evaluation were positively but weakly correlated after controlling for age and total burn surface area (R=0.33, p=0.03). Moreover, pain management with opioids was significantly more common in burn patients with low Clinician Administered PTSD Scale scores (evaluation 1) and high HAMD scores (evaluation 2) (F=6.66, p=0.001).
CONCLUSION
High opioid dose following acute burn trauma might have correlation with depressive symptoms. Monitoring of depressive symptoms may be important following acute burn trauma and consequent opioids pain management, particularly when PTSD symptoms appear minimal during the early stabilization of patients.

Keyword

Burns; Depression; Post-traumatic stress disorders; Opioid analgesics
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