Qualitative and quantitative assessments of pain in anxious and depressed patients : Are there differences?

Abstract

Background: Pain is a multidimensional and subjective experience, and its perception is influenced by sensory, emotional, and behavioral factors. This work aims to evaluate the influence of depression and anxiety in the quantitative and qualitative assessment of chronic pain.

Methods: This is a cross-sectional study carried out at the Multidisciplinary Pain Center of the Clinical Hospital of the Federal University of Minas Gerais. A total of 103 patients were interviewed and evaluated using the following instruments: McGill Questionnaire, visual numerical scale, Hospital Anxiety and Depression Scale and the Medical Outcomes Study SF-36.

Results: The affective, sensory and miscellaneous categories of anxious patients were higher than the nonanxious population (p < 0.05). In the depressed population, the "affective" category was higher than the nondepressed population (p < 0.05). Regarding the anxious and depressed population, the affective, sensory and miscellaneous categories were superior to the nonanxious and nondepressed population (p < 0.05).

Discussion: Depression and anxiety are the most common psychiatric disorders in the population with chronic pain, with a prevalence of 30-40%. In the presence of anxiety and depression, a worse qualitative evaluation was observed. The higher the scores obtained in the assessment of these two mental disorders, the higher the pain index found, and the higher pain index correlates with a lower quality of life.

Conclusion: The presence of anxiety and depression altered the qualitative assessment of pain, making it more unpleasant. The pain index correlated with quality of life without, however, being related to pain intensity.