Psychological factors and delayed healing in chronic wounds.
OBJECTIVE
Studies have shown that stress can delay the healing of experimental punch biopsy wounds. This study examined the relationship between the healing of natural wounds and anxiety and depression.


METHODS
Fifty-three subjects (31 women and 22 men) were studied. Wound healing was rated using a five-point Likert scale. Anxiety and depression were measured using the Hospital Anxiety and Depression Scale (HAD), a well-validated psychometric questionnaire. Psychological and clinical wound assessments were each conducted with raters and subjects blinded to the results of the other assessment.


RESULTS
Delayed healing was associated with a higher mean HAD score (p = .0348). Higher HAD anxiety and depression scores (indicating "caseness") were also associated with delayed healing (p = .0476 and p = .0311, respectively). Patients scoring in the top 50% of total HAD scores were four times more likely to have delayed healing than those scoring in the bottom 50% (confidence interval = 1.06-15.08).


CONCLUSIONS
The relationship between healing of chronic wounds and anxiety and depression as measured by the HAD was statistically significant. Further research in the form of a longitudinal study and/or an interventional study is proposed.
Cole-King
A
A
Wound Healing Research Centre, University of Wales College of Medicine, Cardiff, UK.
Harding
K G
KG
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001007:Anxiety / Q000150:complications*; D002908:Chronic Disease; D003430:Cross-Sectional Studies; D003863:Depression / Q000150:complications*; D005260:Female; D006801:Humans; D007871:Leg Ulcer / Q000523:psychology* / Q000628:therapy*; D016013:Likelihood Functions; D008297:Male; D008875:Middle Aged; D011569:Psychiatric Status Rating Scales; D016037:Single-Blind Method; D011795:Surveys and Questionnaires; D014945:Wound Healing