Anxiety and Depression Can Exacerbate Post-Operative Pain

APRIL 12, 2016
MD Magazine Staff
A study in the British Journal of Pain suggests that anxiety and depression before surgery can significantly influence the amount of pain a patient feels after surgery. The findings are potentially important because they add to the evidence that the subjective experience of pain is worth considering, both before and after a pain intervention.
This study aimed to determine the relationship between the preoperative psychological status and the pain experienced postoperatively in a sample of 304 Caribbean patients. Patients were excluded if they underwent emergency surgery or had local anesthetic procedures or sedation-analgesia not involving an anesthetist, refused to participate in the study, or were unable to perform pain scales on their own.
Patients’ preoperative psychological status was assessed using Hospital Anxiety and Depression Scale (HADS). Researchers also recorded a preoperative “expected” pain score. After surgery, pain scores were assessed at 4 and 24 hours and the maximum pain score over the first day after surgery were recorded.
The overall prevalence of pre-surgery anxiety and depression was 43% and 27%, respectively, based on the HADS scores. Following surgical procedures, 3.9% of participants had no pain, 8.9% had “mild pain,” 22.7% had “moderate” pain, and 64.5% had “severe pain. In all, 70% of patients with anxiety experienced severe pain, compared to 60% without anxiety. Age, gender, ethnicity and type of anesthesia did not impact postoperative pain scores.

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