Anxiety, depression in patients with chronic pancreatitis induce pain, low QOL

Patients with chronic pancreatitis (CP) tend to have psychiatric comorbidities, which are associated with pain and quality of life (QOL), according to a study.

“Where the effect of anxiety on QOL may be mediated via pain, depression is independently related to QOL,” the authors said. “These findings warrant consideration in the management of patients with CP.”

This cross-sectional, multicentre prospective study included 171 patients with CP (mean age, 53.8 years; 60 percent men), who were screened with the Hospital Anxiety and Depression Scale questionnaire. A Hospital Anxiety and Depression Scale score >7 on anxiety or depression subscales indicated the presence of anxiety or depression and was used as surrogate for diagnosis of psychiatric comorbidities.

The authors then compared patient demographics, disease characteristics, QOL (EORTC-QLQ-C30), and pain symptoms (Brief Pain Inventory Short Form) between patients with and without psychiatric comorbidities.

Anxiety was diagnosed in 80 patients (46.8 percent) and depression in 66 (38.6 percent), with overlap in 50 (29 percent). Those with anxiety or depression reportedly had higher pain prevalence, pain severity, and pain interference scores (p<0.001 for all).

In addition, psychiatric comorbidities were associated with reduced global health scores and functional subscales (p<0.001 for all), as well as higher symptom burden (p≤0.03). Depression was independently associated with global health status (p<0.001).

“Abdominal pain, frequent in patients with CP, has a negative impact on QOL,” the authors said. “Psychiatric comorbidities including anxiety and depression are associated with pain.”