Prevalence and Correlates of Depression and Anxiety in Patients with Functional Anorectal Pain

Abstract

Purpose Patients with functional anorectal pain (FAP) often experience psychological distress, impaired quality of life, increased healthcare utilisation, and even suicidal tendencies. However, limited data exists on the psychological correlates of FAP in Chinese patients. Therefore, this study aimed to examine the prevalence of depression, anxiety, and related psychosocial factors in Chinese patients with FAP. Methods We used a cross-sectional research design and recruited 100 patients with FAP from SuBei Hospital’s multidisciplinary clinic for pelvic floor disorders between January and December 2021. Information on patients’ demographic and disease characteristics was also collected. Depressive and anxiety symptoms were assessed using the Patient Health Questionnaire Depression (PHQ-9) and the Generalised Anxiety Disorder Questionnaire (GAD-7). Multiple logistic regression analysis was used to examine factors associated with depression and anxiety. Results The prevalence of depressive and anxiety symptoms among patients with FAP was 55% and 46%, respectively. Being a woman, specific marital status (single, divorced, separated, or widowed), longer FAP duration, and sleep disturbance were significantly associated with an increased risk of depressive symptoms. Additionally, specific marital status (single, divorced, separated, or widowed), sleep disturbance, and high Visual Analogue Scale scores were associated with anxiety symptoms. Conclusion Depressive and anxiety symptoms are prevalent in patients with FAP. Several socio-demographic and clinical predictors have been identified. There is a need for psychologists to be involved in the treatment of patients with FAP. Thus, multidisciplinary treatment may be the optimal treatment strategy.

Psychological status of patients with functional anorectal pain and treatment efficacy of paroxetine in alleviating the symptoms: a retrospective study

“…A total HAMA score < 7 points was considered normal, scores from 7 to 14 indicate possible anxiety, scores from 14 to 21 indicate definite anxiety, scores from 21 to 29 indicate obvious anxiety, and scores > 29 indicate severe anxiety. The Pittsburgh Sleep Quality Index (PSQI, Cronbach alpha: 0.82–0.83) 9 , 32 , 33 assesses the sleep quality of the subjects in the last month. The PSQI is useful in psychiatric clinical practice and research activities.…”

“…At baseline, all patients were evaluated by the Chinese version of the Short-Form McGill Pain Questionnaire-2 (SF-MPQ-2, Cronbach alpha: 0.73–0.95) 35 as well as the VAS. Patients assessed the degree of swelling or other symptoms on a visual analog scale ranging from 0 to 10 9 . The patients were evaluated and recorded again after four weeks of treatment.…”

“…The prevalence of FAP has been gradually increasing in recent years, with a prevalence rate of approximately 6.6% to 11.6% worldwide, most of whom are middle-aged women 7 , 8 . Symptoms of FAP patients often occur repeatedly, accompanied by psychological distress, which can cause defecation disorders, depression, anxiety, and sleep problems 9 , 10 . Symptoms of FAP may be intermittent or continuous during the days and deteriorating in the night due to the supine position 11 , 12 .…”

“…Symptoms of FAP may be intermittent or continuous during the days and deteriorating in the night due to the supine position 11 , 12 . Moreover, functional gastrointestinal symptoms might be also associated with obesity 13 and eating disorders 9 , 14 . Thus, a significant proportion of FAP patients are experiencing unsatisfactory quality of life 15 – 17 .…”

“…Patients with depression and anxiety often suffer from stigma 28 , 29 . Therefore, FAP patients with emotional disturbances often don't disclose their mental condition to non-mental health professionals 9 . Thus, clinicians, especially surgeons, usually ignore the psychological status, sleep quality and quality of life of FAP patients, which may underlie the poor clinical treatment effect of this disease.…”