Acute pain at discharge from hospitalization is a prospective predictor of long-term suicidal ideation after burn injury.
OBJECTIVE
To determine the extent to which pain contributes to risk for suicidal ideation after burn injury.


METHODS
This longitudinal cohort study evaluated participants at discharge, 6 months, and 1 year after burn injury.


METHODS
Inpatient rehabilitation units of multiple regional burn centers.


METHODS
Survivors of major burns (N=128).


METHODS
Not applicable.


METHODS
Pain severity, assessed using the Medical Outcomes Study 36-Item Short-Form Health Survey bodily pain subscale, and passive and active suicidal ideation, assessed by self-report.


RESULTS
At each time point, approximately one quarter to one third of the sample reported some form of suicidal ideation. In logistic regression analyses, pain severity at discharge was the sole consistent predictor of suicidal ideation at follow-up, with greater pain severity being associated with enhanced risk for both passive and active suicidal ideation. These associations were observed even after controlling for discharge mental health.


CONCLUSIONS
These are the first findings to suggest an association between acute pain severity and the development and maintenance of suicidal ideation in burn patients. Further research in this area, including the study of improved pain management programs as a prophylaxis against suicidal ideation, may benefit those who are at elevated suicide risk as a consequence of burn injuries.
Department of Psychiatry and Behavioral Sciences, Johns Hopkins University School of Medicine, Baltimore, MD 21287, USA. redwar10@jhmi.edu
Robert R
RR
Edwards
Gina
G
Magyar-Russell
Brett
B
Thombs
Michael T
MT
Smith
Radha K
RK
Holavanahalli
David R
DR
Patterson
Patricia
P
Blakeney
Dennis C
DC
Lezotte
Jennifer A
JA
Haythornthwaite
James A
JA
Fauerbach
D000328:Adult; D002056:Burns / Q000145:classification / Q000523:psychology* / Q000534:rehabilitation; D005260:Female; D006306:Health Surveys; D006801:Humans; D015601:Injury Severity Score; D016015:Logistic Models; D008297:Male; D010146:Pain / Q000145:classification / Q000523:psychology*; D010351:Patient Discharge; D011446:Prospective Studies; D013405:Suicide / Q000523:psychology*; D013997:Time Factors