Correlation between mental health and pain-related impairment in patients with chronic cancer-related pain.

INTRODUCTION

Cancer-related pain (CRP) has a high prevalence in cancer patients, with almost one-third of patients experiencing moderate to severe pain. Together with psychological problems, CRP is among the most common issues faced by cancer patients. According to the biopsychosocial pain model, pain is closely related to anxiety and depressive disorders, as well as poorer health-related quality of life (QoL) in cancer patients. Due to scarce data on changes in CRP levels and pain impairment in relation to mental disorders over time, this cross-sectional study investigated differences in mental health, QoL, and pain-related impairments depending on pain status and time intervals.

METHODS

A cross-sectional survey was conducted among cancer patients in an academic hospital pain clinic and members of support groups to assess CRP, pain-related impairment (Von Korff Severity Scale), depression, anxiety, stress (Depression, Anxiety, and Stress Scale [DASS]), and QoL (EORTC-QLQ-C30 Version 3). Participants were divided into six different groups by duration of cancer disease (<2 years, 2-5 years, and >5 years) and presence of CRP (pain/no pain).

RESULTS

A total of 256 datasets were evaluated. Patients with CRP (n = 119) showed poorer scores for depression (27.7% vs. 7.3%), anxiety (40.3% vs. 16.1%), stress (29.4% vs. 13.9%), and global QoL (53.8% vs. 16.1%) than patients without pain. The duration of cancer played a minor role in all comparisons between the groups. Female sex was associated with pain-related impairment, whereas a higher global QoL was associated with a slightly reduced odds ratio.

DISCUSSION AND

CONCLUSIONS

Compared to patients without pain, CRP was associated with measurable differences in mental health at all time intervals in this cross-sectional survey, whereas the duration of cancer played a minor role. In the context of the biopsychosocial pain model, the potential negative impact of CRP on psychological well-being should be considered. Early identification of patients with CRP, followed by sufficient pain management and psycho-oncological/psychotherapeutic support for coping with pain in the biopsychosocial model, might improve long-term mental health and prevent pain chronification. In particular, the development of gender-sensitive interdisciplinary treatment approaches appears to have the potential to optimize care.