Does Acute Propranolol Treatment Prevent Posttraumatic Stress Disorder, Anxiety, and Depression in Children with Burns?

Laura Rosenberg, Marta Rosenberg, Sherri Sharp, Christopher Thomas, Helen F. Humphries, Charles E. Holzer, David Herndon, Walter Meyer

Research output: Contribution to journalArticle

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Abstract

Objective: This study examined whether acute propranolol treatment prevented posttraumatic stress disorder (PTSD), anxiety, and depression in children hospitalized in the pediatric intensive care unit for large burns. We hypothesized that the prevalence of PTSD, anxiety, and depression would be significantly less in the propranolol than nonpropranolol groups. Methods: Children who had previously participated in a randomized controlled clinical trial of acute propranolol and nonpropranolol controls were invited to participate in long-term follow-up interviews. Eligible participants from 1997 to 2008 were identified from the electronic medical records, and data were collected in 2010-2011. Measures included the Missouri Assessment of Genetics Interview for Children to assess lifetime PTSD, Revised Children's Manifest Anxiety Scale to assess anxiety, and two depression inventories Children's Depression Inventory and Beck Depression Inventory-II. Results: Of 202 participants, 89 were in the propranolol group and 113 were nonpropranolol controls. Children were an average of 7 years postburn. The average total body surface area burned was 56.4 + 15.1% (range = 24%-99%). The mean dose of propranolol was 3.64 ± 3.19 mg/kg per day (range = 0.36-12.12). The duration of propranolol inpatient treatment days varied, mean days 26.5 ± 19.8. The prevalence of lifetime PTSD in the propranolol group was 3.5% and controls 7.2%, but this difference was not statistically significant. We controlled for administration of pain medications, anxiolytics, and antidepressants overall and no significant differences were detected in the rates of PTSD, anxiety, or depression. Conclusions: The prevalence of PTSD, anxiety, and depression was similar in children who received propranolol acutely and those who did not. This may be influenced by the standard of care that all children received timely pharmacotherapy for pain and anxiety management and psychotherapy beginning in their acute phase of treatment.

Original languageEnglish (US)
Pages (from-to)117-123
Number of pages7
JournalJournal of Child and Adolescent Psychopharmacology
Volume28
Issue number2
DOIs
StatePublished - Mar 1 2018

Fingerprint

Post-Traumatic Stress Disorders
Burns
Propranolol
Anxiety
Depression
Therapeutics
Equipment and Supplies
Manifest Anxiety Scale
Interviews
Pediatric Intensive Care Units
Hospitalized Child
Electronic Health Records
Body Surface Area
Anti-Anxiety Agents
Pain Management
Standard of Care
Psychotherapy
Antidepressive Agents
Inpatients
Randomized Controlled Trials

Keywords

  • anxiety
  • burns
  • children
  • depression
  • posttraumatic stress disorder
  • propranolol

ASJC Scopus subject areas

  • Pediatrics, Perinatology, and Child Health
  • Psychiatry and Mental health
  • Pharmacology (medical)

Cite this

Does Acute Propranolol Treatment Prevent Posttraumatic Stress Disorder, Anxiety, and Depression in Children with Burns? / Rosenberg, Laura; Rosenberg, Marta; Sharp, Sherri; Thomas, Christopher; Humphries, Helen F.; Holzer, Charles E.; Herndon, David; Meyer, Walter.

In: Journal of Child and Adolescent Psychopharmacology, Vol. 28, No. 2, 01.03.2018, p. 117-123.

Research output: Contribution to journalArticle

Rosenberg, Laura ; Rosenberg, Marta ; Sharp, Sherri ; Thomas, Christopher ; Humphries, Helen F. ; Holzer, Charles E. ; Herndon, David ; Meyer, Walter. / Does Acute Propranolol Treatment Prevent Posttraumatic Stress Disorder, Anxiety, and Depression in Children with Burns?. In: Journal of Child and Adolescent Psychopharmacology. 2018 ; Vol. 28, No. 2. pp. 117-123.
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abstract = "Objective: This study examined whether acute propranolol treatment prevented posttraumatic stress disorder (PTSD), anxiety, and depression in children hospitalized in the pediatric intensive care unit for large burns. We hypothesized that the prevalence of PTSD, anxiety, and depression would be significantly less in the propranolol than nonpropranolol groups. Methods: Children who had previously participated in a randomized controlled clinical trial of acute propranolol and nonpropranolol controls were invited to participate in long-term follow-up interviews. Eligible participants from 1997 to 2008 were identified from the electronic medical records, and data were collected in 2010-2011. Measures included the Missouri Assessment of Genetics Interview for Children to assess lifetime PTSD, Revised Children's Manifest Anxiety Scale to assess anxiety, and two depression inventories Children's Depression Inventory and Beck Depression Inventory-II. Results: Of 202 participants, 89 were in the propranolol group and 113 were nonpropranolol controls. Children were an average of 7 years postburn. The average total body surface area burned was 56.4 + 15.1{\%} (range = 24{\%}-99{\%}). The mean dose of propranolol was 3.64 ± 3.19 mg/kg per day (range = 0.36-12.12). The duration of propranolol inpatient treatment days varied, mean days 26.5 ± 19.8. The prevalence of lifetime PTSD in the propranolol group was 3.5{\%} and controls 7.2{\%}, but this difference was not statistically significant. We controlled for administration of pain medications, anxiolytics, and antidepressants overall and no significant differences were detected in the rates of PTSD, anxiety, or depression. Conclusions: The prevalence of PTSD, anxiety, and depression was similar in children who received propranolol acutely and those who did not. This may be influenced by the standard of care that all children received timely pharmacotherapy for pain and anxiety management and psychotherapy beginning in their acute phase of treatment.",
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