# Severity of Pain at Admission and Development of Symptoms of Anxiety and Depression: A Study of Burn Patients at a Tertiary Healthcare Facility in Ghana

## TL;DR

This study finds that severe pain at admission is linked to higher anxiety and depression symptoms in burn patients within a week.

## Contribution

The study establishes a direct link between initial pain severity and subsequent anxiety/depression symptoms in burn patients.

## Key findings

- Most burn patients experienced severe pain and developed significant anxiety and depressive symptoms.
- Higher pain scores at admission were significantly associated with increased anxiety and depression symptoms.
- Age, burn cause, and TBSA influenced depression and anxiety symptom severity.

## Abstract

Background

Burns remain a global public health concern and one of the major causes of painful injury, which impacts patients physically and psychologically. Pain causes more suffering in the acute stage and rehabilitation in burn patients, which is associated with anxiety, depression, and post-traumatic stress disorder that can lead to long-term consequences, which negatively affects the quality of life (QoL) of the patient.

Objective

This study aimed to determine the influence of the severity of pain at admission on the development of symptoms of anxiety and depression among burn patients within the first week of admission.

Methods

An analytical cross-sectional study was conducted among adult burn patients at the Burns Centre of the Korle-Bu Teaching Hospital. Patients’ demographic and clinical characteristics, such as age, cause of burns, degree of burns, and percentage of total body surface area (TBSA), were recorded. Hospital Anxiety and depression scale (HADS) was used to assess anxiety and depression symptoms, while the Visual Analog Scale (VAS) was used to evaluate the intensity of pain. Simple linear regression was used to determine the influence of the severity of pain at admission on symptoms of anxiety and depression.

Results

Sixty-five adult inpatients were enrolled, with a mean age of 35.9 years. About 92% presented with severe pain, and two-thirds developed severe anxiety (66.2%) or depressive (67.7%) symptoms. The mean (±SD) anxiety symptoms, depression symptoms, and pain scores were 11.4(±2.7), 11.8(±3.4), and 8.5(±1.6), respectively. Mean anxiety symptom scores were significantly different between the age groups, %TBSA, and severity of pain. Mean depression symptom scores were significantly different between the severity of pain and the cause of burn injury. There was a significant positive relationship between the severity of pain on admission and the level of depression and anxiety symptoms.

Conclusion

Patients with burn injury present with severe pain at admission, and the majority develop significant anxiety and depressive symptoms within the first week of admission. The intensity of pain at admission is significantly associated with the level of anxiety and depression.