The impact of pruritus, pain, and burn severity on the mental health of burn survivors: A prospective study

To prospectively investigate the relationship between pruritus, pain, and total body surface area (TBSA) with the mental health of burn survivors during the first six months of recovery. In this prospective longitudinal study, 78 adult burn patients admitted to a specialized burn center were assessed at one, three, and six months post-injury. Mental health was assessed using the 28-item General Health Questionnaire (GHQ-28), while pruritus and pain intensity were evaluated using Numeric Rating Scales (NRS). Correlational and multiple linear regression analyses were performed to identify predictors of mental health. Significant improvements in mental health and reductions in pruritus intensity were observed over the six-month (p < 0.001). At all time points, poorer mental health (higher GHQ-28 scores) was positively associated with greater pruritus intensity, pain intensity, and TBSA; however, in multivariable analysis, only TBSA and pruritus intensity remained as independent predictors, while pain lost its significance. Specifically, Spearman correlations for pruritus were modest (month 1: ρ = 0.227, p < 0.001; month 3: ρ = 0.283, p < 0.001; month 6: ρ = 0.221, p < 0.001), whereas correlations for pain (ρ = 0.566–0.684, p < 0.001) and TBSA (ρ = 0.757–0.885, p < 0.001) were stronger. In multivariable analysis, TBSA and pruritus intensity were independent predictors of GHQ-28. Multiple regression analysis revealed that only TBSA and pruritus intensity were significant independent predictors of mental health scores across all follow-ups. These findings underscore the clinical importance of prioritizing aggressive and specialized management of pruritus, not only for physical comfort, but as an essential component of mental health care for this vulnerable population.