Psychological disorders in relation to pain syndrome in patients with colorectal cancer

Abstract

Aim. The principle aim is to investigate the relationship between psychological distress, pain syndrome and clinical features in colorectal cancer patients. Methods. The study assessed forty-nine patients undergoing chemotherapy from Cancer Institute “Ion Chiricuta” Cluj-Napoca admitted between 2016 and 2017 with locally advanced or metastatic colorectal cancer. For each patient, pain intensity was evaluated using a visual analogue scale, whereas depression and anxiety levels were evaluated using Beck Depression and State-Trait Anxiety Inventories. All evaluations were determined at their first presentation in the hospital before treatment initiation. Correlations between demographic characteristics, pain evaluation and mental disorders were realized using Chi-squared tests (χ2) and Spearman’s rho. Results. Pain was observed in 76% of patients, 54% of whom had moderate to increased pain. Twenty-nine percent of patients presented with nociceptive pain, whereas 20% had neuropathic pain. In 27% of patients, the pain was mixed. Depression was moderate to severe in 53% of patients, and high levels of anxiety were found in 24% of patients. Levels of anxiety and depression did not correlate with demographic characteristics. There were correlations between the pain type and its level. Neuropathic pain correlated with moderate pain, while mixed pain was correlated with intense pain (p=0.0003). Tumor site was correlated with level of anxiety: colorectal cancer was associated with mild anxiety, rectal cancer was associated with moderate anxiety, and patients with anal canal cancer presented increased anxiety (p=0.026). Conclusion. High pain frequency is associated with high anxiety and depression levels in colorectal cancer patients. Pain intensity is correlated with pain type, while psychological disorders are correlated with tumor site.