Anxiety and Depression Among Non-Facial Burn Patients at a Tertiary Care Center in Pakistan

Abstract

Introduction: A patient who suffers from burn injuries can be subjected to various mental and psychological conditions that can adversely affect their health and wellbeing. Material and methods: A cross-sectional study was conducted between 1st September 2019 and 30th March 2020 in a tertiary care hospital in Pakistan. Patients were selected in the outpatient department and followup was done at two and four weeks following definitive. Some 225 patients in our study fulfilled the inclusion criteria. Patients were assessed using Urdu translated scales. Hamilton Anxiety Rating Scale (HAM-A) and Hamilton Depression Rating Scale (HAM-D) were used. Data were analyzed with the help of SSPS software version 13.0. Result: Out of 119 (52.8 %) male patients, the highest percentage was of accidental injuries 106 (89%) followed by suicidal burns 9 (7.5%). A similar trend was seen in females; out of n=106 females, 92 (86%) presented with accidental burn injuries and only 11 (10%) patients have a history of suicidal burns. A fraction of the sample had a history of homicidal burn injuries, with 4 (3%) male and 3 (2%) female patients. The variation of anxiety level and depth of burn varied considerably. Among patients who suffered superficial thickness burns (n=105, 47%), 69.5% of patients experienced mild anxiety symptoms. Only 28 (26.6%) patients had moderate anxiety and severe anxiety was the lowest, at only 3.8% (n=4). A similar trend was observed in deep burn patients, but the level of severe anxiety was significantly higher at 26%. This was statistically significant (p < 0.05). Deep burn patients had the highest percentage (n=54, 45.3%) of very severe depression compared to only 10% in superficial burns. The variation between the two categories was statistically significant (p < 0.05). The majority of (35.2%) patients experienced mild symptoms of depression and this correlated with superficial burn injuries. Conclusion: A burn injury can seriously affect the mental wellbeing of patients. With the severity of burn injury we saw that severe depression was prevalent. This aspect must be taken into consideration when treating such patients and it warrants a multidisciplinary team (MDT) strategy.

Frontal lobe hemodynamics detected by functional near-infrared spectroscopy during head-up tilt table tests in patients with electrical burns

“…Burns can profoundly affect a patient's psychological and emotional state (Thompson and Kent, 2001 ). One study has shown that symptoms of anxiety and depression are related to the depth of burns (Bhatti et al, 2020 ). However, conflicting results were also reported that showed no difference in the incidence of anxiety or depression after burns (Nilsson et al, 2019 ).…”

“…However, few studies have examined the functional changes in the brain, especially the ANS function, due to electrical injury (Brandon et al, 2009 ; Ramati et al, 2009 ). Burns are commonly known to have profound effects on an individual's psychological and emotional well-being (Bhatti et al, 2020 ). However, there is also a study reporting no significant difference in the incidence of post-burn anxiety or depression (Nilsson et al, 2019 ).…”

A systematic review of self-esteem and related factors among burns patients

“…The results of another study showed that the rate of depression in burn patients was a significant relationship with the severity of burns. Showed that, depression increases with the severity of burns [ 51 ]. A review study found that burn survivors had higher suicidal ideation and a higher suicide rate than the general population [ 52 ].…”

A systematic review of social support and related factors among burns patients

“…32 Burns is the application of heat, electric current, flammable materials and chemicals to the internal and external surfaces of the body, which can lead to superficial and deep damage. 33 Burn injuries can affect human life, such as physical and mental health, functional skills, and performance. [34][35][36][37][38] Changes in appearance, social isolation, stress, anxiety, depression, low self-esteem, unemployment, financial burden and family problems can occur in these patients.…”

“…[34][35][36][37][38] Changes in appearance, social isolation, stress, anxiety, depression, low self-esteem, unemployment, financial burden and family problems can occur in these patients. 33 These burn complications can be exacerbated without adequate social support. 39 Social support is help from others that the patient can understand and accept.…”