The impact of anxiety and depressive symptoms on chronic pain in conservatively and operatively treated hand surgery patients

Abstract

Niklaus Egloff,1,2 Barbara Wegmann,1 Bettina Juon,3 Stefanie Stauber,1 Roland von Känel,2,4 Esther Vögelin3 1Division of Psychosomatic Medicine, Department of General Internal Medicine, Inselspital Bern University Hospital, 2Department of Clinical Research, University of Bern, 3Department of Plastic and Hand Surgery, Inselspital Bern University Hospital, Bern, 4Department of Psychosomatic Medicine, Clinic Barmelweid, Barmelweid, Switzerland Abstract: The aim of this prospective study was to examine to what extent anxiety and depressive symptoms predict the level of pain at 4-month follow-up in hand surgery patients. A total of 132 consecutive patients (mean age: 51.5±17.1 years, 51.9% female) of a tertiary center for hand surgery participated in this study. The patients underwent conservative or operative treatment, depending on the nature of their hand problem. The initial pain assessment included psychometric testing with the hospital anxiety and depression scale. Ninety-nine patients underwent operative treatment and 33 patients were conservatively treated. At 4-month follow-up, the amount of pain was measured with a visual analog scale (0–10). After controlling for age, sex, and pre-surgical pain intensity, depressive symptoms were a significant predictor for increased pain levels at follow-up in conservatively treated patients. In operatively treated patients, anxiety symptoms showed a trend for being a predictor of pain level at follow-up. The findings support the assumption that psychological factors may have an impact on pain outcome in patients presenting to hand surgery clinics. Keywords: chronic pain, hand surgery, depressive symptoms, anxiety

Keywords

• Chronic pain
• hand surgery
• depression
• anxiety.