269 Prevalence of Depressive Symptoms Over Time in Pediatric Burn Survivors

Abstract

Prior research shows that adult pediatric burn survivors have a higher incidence of mental health issues when compared to the general population. The aim of this study is to examine the prevalence of depressive symptoms over time in children being treated in outpatient burn clinics. The Multi-Center Benchmarking Study includes four burn centers that administered the Burn Outcomes Questionnaire (BOQ) to parents of children aged 5–18 to assess physical and psychosocial recovery from burn injuries. Children were eligible for the study if they were English or Spanish speaking, and had experienced a total body surface area (TBSA) burn ≥20% or a burn to a critical area (face, hands, feet, genitalia). Surveys were administered at the first return to the clinic after discharge from inpatient care (baseline), 3, 6, 12, 18, 24, and 36 months after discharge. This study focuses on the question, “This child feels depressed and talks about death” with possible answers: “None of the time”, “Some of the time”, “About half of the time”, “Most of the time”, and “All of the time”. Responses other than “None of the time” were considered a “positive” depressive or suicidal response. Surveys were collected from the parents of 836 total patients over the course of 7 time points. The rate of “positive” responses decreases over time among the full sample of cases at each time point as well as for subjects that had complete data at all 7 time points (Table 1). Around 50% of patients maintained a “positive” response from each successive time point. From baseline to 36 months, 45% of children had a “positive” response for at least one time point, while only 2% had a “positive” response at all time points. Over all 7 time points, the majority (72%) of children with a “positive” response were rated as being depressed “Some of the time” and only a small percentage (4%) of patients with a “positive” response were rated as being depressed “All of the time”. This study shows almost half of children recovering from burn injuries experience depressive symptoms at least once in the first 3 years of recovery. The prevalence of these symptoms is greatest at baseline and decreases until it tapers off around 12% at 2 to 3 years. Many children’s symptoms persist over successive time points, suggesting a lack of mental health evaluation. This study indicates a need to prioritize screening and treatment of mental health issues in children recovering from burn injuries, not only early in recovery, but 2 to 3 years post-injury.