Functional impairment, not pain, predicts anxiety and depression in Nigerian cancer patients: A cross-sectional study of nociceptive and neuropathic pain.

OBJECTIVES

To investigate the relationship between pain (including neuropathic pain [NP]), functional impairment, and anxiety/depression among Nigerian cancer patients.

METHODS

This cross-sectional study enrolled 126 adult cancer patients at a Nigerian teaching hospital. Pain intensity, NP (painDETECT), functional impairment (Sheehan Disability Scale), and anxiety/depression (Hospital Anxiety and Depression Scale, HADS) were assessed.

RESULTS

Prevalence rates were 37.3% for anxiety and 35.7% for depression. Pain was reported by 82% of patients (predominantly mild), while NP occurred in 23%. Bivariate and correlation analyses showed no significant association between pain (including NP) and anxiety/depression (p > 0.05). However, functional impairment was strongly correlated with both outcomes (HADS-A: r = 0.470; HADS-D: r = 0.675; p < 0.001). Multivariate regression identified functional impairment as the strongest independent predictor of anxiety (odds ratio [OR] = 7.537) and depression (OR = 8.625). Pain intensity and NP were not retained as significant predictors.

SIGNIFICANCE OF

RESULTS

Functional impairment, not pain nor NP, independently predicts anxiety and depression in Nigerian cancer patients. Routine functional screening may be more clinically useful than pain-focused assessments for identifying psychological distress in resource-limited oncology settings.