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Wounds heal more quickly if patients are relieved of stress

BMJ 2003; 327 doi: (Published 04 September 2003) Cite this as: BMJ 2003;327:522
  1. Claire Laurent
  1. Banbury

    Writing about emotional events can speed up the rate at which wounds heal, according to a study carried out by Suzanne Scott and colleagues from the Unit of Psychology, King's College, London, and presented at the annual conference of the British Psychological Society's health division this week.

    Previous research by psychologists has found that disclosure of traumatic experiences has a positive effect on the immune system. But, according to Ms Scott, a doctoral student, this study takes those findings one step further by showing a clear physical effect as a result of an emotional release.

    Half of the 36 participants were required to write about an emotional event in their lives—preferably one they had not talked much about before—using plenty of emotional language. The other half were asked to write on more trivial matters, such as time management, avoiding emotional language. The study was controlled for psychological factors such as loneliness, self esteem, perceived stress, and optimism and for physical factors such as smoking and drinking.

    “They came in over three days for 20 minutes each day,” said Ms Scott. “A lot of them initially felt quite distressed but also relieved by it [writing about an emotional event]. The theory is that it is releasing a pressure that they have kept in by not previously disclosing it to anyone.”

    In the second week all the participants received an identical wound in the upper arm in the form of a punch biopsy. The results showed that the participants who wrote about the traumatic events had significant smaller wounds 14 days after the puncture. The researchers also found that higher levels of stress and psychological distress were associated with delayed wound healing.

    “The emotional disclosure, which was the writing, was shown to have an effect on something physical, rather than just a subtle change in the immune system. These findings have implications for the development of relatively brief and easy interventions that could have beneficial effects on wound healing,” said Ms Scott.

    In a separate but associated study Professor John Weinman, from King's College, London, found that it is not just levels of stress experienced by patients before they undergo surgery that affects their recovery afterwards, as has been previously found. Ongoing stresses that they experience after surgery can also have a detrimental effect on their recovery.

    Professor Weinman, who gave the keynote address at the annual conference, at Staffordshire University, said, “These research findings can help patients and will be important for developing interventions for patients undergoing different types of surgery.”

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