title: Opioid Analgesics and Depressive Symptoms in Burn Patients: What Is the Real Relationship?
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).
  
  
  CONCLUSIONS
  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.
authors.affiliation: Department of Psychiatry, Hallym University Sacred Heart Hospital, Anyang, Korea.
authors.forename: Narei
authors.initials: N
authors.lastname: Hong
authors.affiliation: Department of Psychiatry, Hallym University Sacred Heart Hospital, Anyang, Korea.
authors.forename: Myung Hun
authors.initials: MH
authors.lastname: Jung
authors.affiliation: Department of Psychiatry, Hallym University Dongtan Sacred Heart Hospital, Hwaseong, Korea.
authors.forename: Jee Wook
authors.initials: JW
authors.lastname: Kim
authors.affiliation: Department of Burn Surgery, Hallym University Hangang Sacred Heart Hospital, Seoul, Korea.
authors.forename: Wook
authors.initials: W
authors.lastname: Chun
authors.affiliation: Department of Psychiatry, Hallym University Kangnam Sacred Heart Hospital, Seoul, Korea.
authors.forename: Ihn-Geun
authors.initials: IG
authors.lastname: Choi
authors.affiliation: Department of Anatomy and Neurobiology, Hallym University College of Medicine, Chuncheon, Korea.
authors.forename: Tae-Cheon
authors.initials: TC
authors.lastname: Kang
authors.affiliation: Department of Neuropsychiatry, Chung-Ang University Hopital, Seoul, Korea.
authors.forename: Baik Seok
authors.initials: BS
authors.lastname: Kee
authors.affiliation: Department of Neuropsychiatry, Hallym University Hangang Sacred Heart Hospital, Seoul, Korea.
authors.forename: Boung-Chul
authors.initials: BC
authors.lastname: Lee
keywords: Burns; Depression; Opioid analgesics; Post-traumatic stress disorders